Clinical analysis of open reduction and ligament repair for treatment of trimalleolar ankle fracture with syndesmotic separation

JU Jinyong; XIAO Haijun; SHI Weizhe; YU Du

doi:10.3969/j.issn.1671-6450.2016.05.012

Abstract：Objective To explore the therapeutic effect of open reduction and ligament repair for treatment of trimal-leolar ankle fracture with syndesmotic separation.Methods From January 2012 to December 2014, 43 cases of trimalleolar ankle fracture with syndesmotic separation came to our hospital for treatment.They were all treated by open reduction and in-ternal fixation:external malleolus with locking plate fixation, posterior malleous with 2-3 pieces of screws fixation, medial malleolus with 1-2 pieces of screws fixation.We fixed three ankle to stabilize the ankle joint, then checked and repaired del-toid ligament, tibiofibular posterior ligament and so on.All cases were confirmed by fluoroscopic image in the external rotation position after operation.Every gap of tibiofibular syndesmosis of 43 cases was less than 5mm, which indicates syndesmotic sta-bilization.So the tibiofibular syndesmosis of 43 cases was not fixed.Talus before and after translation test negative, suggesting that the ankle joint stability.They were followed up on a regular basis.According to Baird-Jackson’ s standar of ankle joint, they were graded.Results 43 cases were all followed up ranging from 8-24 (16.0 ±0.5) months.The incision healing time was ranging from 8-15 (12.3 ±1.4) days.If all were healed, the average healing time was 4-6 (4.7 ±0.5) months. The mean Baird-Jackson ankle-hindfoot score was 84-98(96.4 ±5.6) points.34 cases (79.1%) were excellent,5 cases (11.6%) were good;4 cases (9.3%) were moderate,the percentage of excellent or good clinical results was 90.7%.Con-clusion Open reduction and ligament repair for treatment of trimalleolar ankle fracture with syndesmotic separation can fix the ankle joint and tibiofibular syndesmosis, which has an evident effect.