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Larger posterior malleolar fragment size in trimalleolar fractures linked to poorer outcomes
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Researchers in Singapore have determined a connection between the posterior malleolar fragment size in trimalleolar fractures and the likelihood of undesirable postoperative outcome.
“Patients have poorer functional outcome with increasing posterior malleolar fragment size in trimalleolar fractures,” Choon Chiet Hong, MBBS, MRCS, and colleagues wrote in the study.
Hong and colleagues conducted a retrospective review of 31 patients with a mean age of 46 years who underwent trimalleolar fracture repair surgery. Olerud and Moleander (O&M) scores were analyzed as well as the ability to return to sports 1 year after surgery.
Of the 21 patients who completed functional outcome surveys, 11 patients noted residual pain, 13 patients had persistent ankle stiffness and 10 patients had persistent ankle swelling at 1 year postoperatively. Poorer O&M scores were observed as the size of the posterior malleolar fragment increased. Patients with Weber B ankle fractures had higher O&M scores than patients with Weber C fractures.
Prior to injury, 12 patients were involved in sports, of which four patients were able to return to their preoperative level of play at 1-year follow-up. Three patients were unable to return to sports.
“Residual clinical and functional deficits should be emphasized to patients prior to surgery,” Hong and colleagues concluded. “In terms of sporting activities, at least one quarter of patients will not return to sports.”—by Christian Ingram
Disclosure: Hong has no relevant financial disclosures.
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