Journal of Musculoskeletal Trauma

Posterior Anti-Glide Plating for Supination External Rotation Type Lateral Malleolar Fractures: Clinical Comparison of Locking versus Non-Locking One-Third Semi-Tubular Plate Fixation: Jun Young Lee, Yong Jin Cho, Dong Hyuk Cha, Hyun Bai Choi, Jung Ho Lee; J Korean Fract Soc 2022;35(2):57-62. Published online April 30, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.2.57

Abstract PDF: Purpose
The purpose of this study was to evaluate and compare the clinical and radiological outcomes between locking plates and non-locking plates using posterior anti-glide plating for supination external rotation type lateral malleolar fractures.
Materials and Methods
A total of 50 patients who underwent internal fixation of posterior anti-glide plating due to lateral malleolar fractures, classified as supination-external rotation (SER) as per the Lauge-Hansen classification system, at our hospital from January 2017 to November 2018 were retro-spectively evaluated. Patients were divided into two groups: 1/3 semi-tubular locking plate (24 patients) and 1/3 semi-tubular non-locking plate (26 patients). A radiographic assessment was performed after surgery to evaluate the time of bone union. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional score was measured after the surgery to evaluate the clinical outcomes.
Results
The two groups showed similar distributions in sex, age, height, body mass index, fracture pattern, and mean follow-up period. Complete bone union was obtained in all cases and the mean bone union time was 13.00±3.38 weeks in Group 1 and 12.92±3.26 weeks in Group 2 (p=0.87). The mean AOFAS score at 24 weeks was 95.66±2.86 in Group 1 and 95.84±2.79 in Group 2 (p=0.82). The mean AOFAS score at 48 weeks was 97.25±3.54 in Group 1 and 96.57±3.07 in Group 2 (p=0.47). Two cases of complications were observed in the non-locking plate group.
Conclusion
For the treatment of Lauge-Hansen SER type lateral malleolar fracture, internal fixation us-ing locking 1/3 semi-tubular plate and non-locking 1/3 semi-tubular plate are both favorable fixation methods.

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Surgical Fixation with Biodegradable Plate for the Treatment of Ankle Fractures: Jae Young Cho, Jin Whan Kim, Sang Eun Kim, Kyung Chil Jung, Seung Hyun Choi; J Korean Fract Soc 2008;21(1):31-36. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.31

PURPOSE
The purpose of this article is to show the efficacy of a biodegradable plate for treating lateral malleolar fractures in the ankle joint.
MATERIALS AND METHODS
The 20 patients who underwent an open reduction and internal fixation for lateral malleolar fractures in the ankle joint from February, 2006 to February, 2007 in our hospital were enrolled into the study. The average age of the patients was 49.7 years and the average follow-up period was 5.6 months. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer et al.
RESULTS
Average radiological bone union time was 10.5 weeks. The clinical result was excellent in 19 cases (95%), good in 1 case (5%). There was one case of minimal displacement less than 1 mm, associated with anterior distal tibio-fibular ligament avulsion fracture.
CONCLUSION
For proper patients, a biodegradable plate is an effecttive alternative implant for stabilizing lateral malleolar fractures in the ankle joint, because there is no requirement for subsequent removal and slow resorption in vivo.

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Delayed Foreign-body Reaction of Ankle Fracture Treated with a Biodegradable Plate and Screws - A Case Report -
Chul-Hyun Park, Dae-Hyun Song, Jae Ho Cho
Journal of the Korean Fracture Society.2012; 25(2): 142. CrossRef

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The Necessity of Deltoid Ligament Repair in Lateral Malleolar Fracture Combined with Medial Clear Space Widening: Bo Kyu Yang, Sung Ho Hahn, Seung Rim Yi, Young Joon Ahn, Jae Ho Yoo, Min Seok Kim, Byung June Chung; J Korean Fract Soc 2005;18(3):281-285. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.281

Abstract PDF: PURPOSE
To evaluate the necessity of deltoid ligament repair in lateral malleolar fracture associated with medial clear space widening.
MATERIALS AND METHODS
The 82 cases of 82 patients received surgical treatment for lateral malleolar fracture with medial clear space widening in our hospital from Jan. 1996 to Feb. 2002. 73 male and 9 female patients were included respectively. Average follow-up period was 13.2 month (12~50). The methods of internal fixation of lateral malleolar fracture were 66 cases by cortical screw, 16 by plate and screws, and 9 by transfixing screw.
RESULTS
Satisfactory reduction was obtained in 65 of 73 cases by only internal fixation of lateral malleolar fracture. Transfixing screw was needed in 8 cases. There was no need for repair of deltoid ligament. In clinical evaluation, no cases of limitation of movement in ankle was seen at final follow-up time. In radiologic evaluation, average medial clear space widening before operation was 5.89 mm (4.5~13 mm) and that of last follow-up time was 2.54 mm (1.5~3.5 mm). 95.2% was above good result.
CONCLUSION
In treatment of unstable lateral malleolar fracture associated with medial clear space widening due to rupture of deltoid ligament, we obtained satisfactory result by accurate anatomical reduction or internal fixation. In these cases, there were no need for repair of deltoid ligament.

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Surgical Treatment of Internal Malleolar Fracture of the Ankle: Rush Rod Versus Plate Osteosynthesis: Hak Jun Kim, Kwon Ick Ha, Jae Ik Shim, Taik Seon Kim, Jeong Ro Yoon, Young Bae Kim, Woo Seung Lee, Jae Young Chang; J Korean Soc Fract 2003;16(4):519-525. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.519

Abstract PDF: PURPOSE
We evaluated the results between the methods of open reduction and internal fixation using plate and screws and the methods of closed reduction and fixation with rush pin in lateral malleolar fractures.
MATERIALS AND METHODS
We analysed the 33 fractures of lateral malleolus which had been treated by open reduction and internal fixation using plate and screws or closed reduction and fixation with rush pin from January 1995 to January 2002 and had been observed over 1 year. The 33 patients were observed for the comparison of radiologic and clinical results in according to the measure of McLennan and Ungersma.
RESULTS
Among the 33 cases, 15 cases were treated by open reduction and internal fixation with plate, and 18 cases were treated by closed reduction and Rush rods fixation. In according to the measure of McLennan and Ungersma, good radiologic result was 60% (9 cases) and excellent clinical result was 27% (4 cases) in plate fixation, and good radiologic result was 61% (11 in 18 cases) and excellent clinical result was 39% (7 in 18 cases) in Rush rods fixation.
CONCLUSION
In ankle fractures of elderly patients who have soft tissue problems and osteoporotic bony quality, radiologic and clinical results of internal fixation of distal fibula were relatively same between fixation with plate and screws and Rush rods. Therefore, closed reduction and internal fixation with Rush rods is one of the good treatment modalities of distal fibular fracture.

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Pitfalls in Treatment of Lateral Malleolar Frcture with Plate and Screws: Jong Min Sohn, Ju Hae Jahng, Nan Kyung Ha, Dae Hyun Baek, Hyoung Gwan Kim, Bong Heon Hyun; J Korean Soc Fract 1998;11(4):900-905. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.900

Abstract PDF

The goal in treatment of ankle fracture is the restoration of normal ankle function. Although controversy still exists over the best method of treatment, recent ariticles emphasize importance of the anatomic reduction of fibula and the benefits of early mobilization when adequate fixation is accomplished. When we fix fracture of lateral alleolus with plte and screws, the distal screws should engage the medial cortex of the fibula but not protrude into the talofibular joint. Because the penetration of screws into ankle joint may be the cause of postoperative pain and opst-traumatic arthritis. This article has reviewed a series of 36 ankle fractures, treated from March 1993 to January 1997, using plate and screws. In order to analyse the influence of the penetration of screws into the ankle joint, all fractures were classified according to the penetrating length of screw from medial cortex of lateral malleolus. Thse with the end of the screw protnided more than 2mm into joint were clssified group I, those with less than 2mm groupp II, those with no engagement group III. The results obtained from this study were as follows: 1. According to clinical and radiolgraphic assessment of the results of the treatment, open reduction and internal fixation using plate and screws in treatment of lateral malleous was a satisfactory method. The excellent or good results were achieved in 28 patients among the 36 patients (77.8%). 2. Average time of bony union was not different significally among the three groups. 3. The gain of full range of motion was delayed in group I. 4. Patients of group I complained persistent pain and discomfort more frequently than the other groups. 5. In the treatment of lateral malleolar fracture, the distal screws should engage the medial cortex of fibula to gain firm fixation,but should not protrude more than 2mm into the ankle joint.

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Features of Lateral Malleolar Fractures in Elderly Patients and Clinical Outcome of Locking Compression Plate Fixation
Seok-Min Hwang, Hong-Geun Jung, Hyung-Jin Chung, Joon-Sang Eom, Dong-Oh Lee, Jung-Hyun Cho, Jong-Tae Park
Journal of the Korean Orthopaedic Association.2016; 51(1): 77. CrossRef

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The Inyo Nail for the Lateral Malleolus Fracture of the Ankle: Joon Young Kim, Young An Choi, Chang Goo Shim, Bo Seok Kong; J Korean Soc Fract 1990;3(2):252-258. Published online November 30, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.2.252

Abstract PDF: The incidence of ankle fracture has been steadily increasing due to a number of traffic accident and was partly related to improved leisurely life style and outdoor activities. So, many methods for treatment of ankle fracture was introduced and some of them attract our attention. By accurate anatomical reduction and rigid fixation, maintenance of the stability of talus in ankle mortise is a goal of ankle fracture treatment. The Inyo nail is a new intramedullary device that was specially designed for the provention of shortening and ratational deformity which may occur in other conventional treatment method. The authors analysed 33 cases of lateral malleolus fracture treated conservatively(13 cases), operatively using Inyo nail(6 cases), other conventional fixational device(14 cases) from March 1987 to March 1989 and reports the indications and problems in operating technique using Inyo nail.

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