Injury characteristics and surgical outcomes of pronation external rotation ankle fractures

ZHUANG Ying-feng; ZHANG Xu-ming; ZHOU Shi-guo; LIN Xing-sheng; SHI Song-chang

doi:10.3969/j.issn.1009-4237.2017.10.008

Abstract：Objective To explore the injury characteristics and surgical outcomes of pronation external ro-tation ankle fracture. Methods Twenty-one cases with pronation external rotation ankle fracture treated by surgery between Jan. 2011 and Feb. 2014 were retrospectively analyzed. There were 11 males and 10 females,with a mean age of 33. 9 years(range,16-57 years old). According to the preoperative X-ray and CT scan,posterior malleolar fractures,syndesmosis malreduction,dislocation of the tibiotalar joint,and the fragments of the tibiotalar joint were observed. The Baird-Jackson score was used to assess the outcome of the surgery. Results There were 19 cases of Ⅳ degree pronation external rotation ankle fractures and 2 cases of Ⅲdegree pronation external rotation ankle frac-tures. There were 18 cases of syndesmotic malreduction,among whom 15 patients were treated with syndesmotic sta-bilization by screw fixation. There were 14 cases of both posterior and lateral dislocation,1 case of lateral disloca-tion,1 case of posterior semi-dislocation,and 5 cases without dislocation. The rate of dislocation was 76. 2％(16/21). For the 7 cases of posterior malleolar fractures,there were fragments behind the collapse of distal tibial articu-lar surface. According to the Baird-Jackson score,10 cases were excellent,6 were good,5 were fair,and the excellent and good rate was 76. 2％(16/21). Conclusion Pronation external rotation Ⅲ degree and Ⅳ degree ankle frac-tures are often combined with tibiotalar joint dislocation and syndesmotic injury, which requires stabilization by screw. Stable internal fixation and anatomic reduction are good solutions for ankle fracture,which can obtain satis-factory outcomes.