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A prospective study of functional outcome of Trimalleolar ankle fracture treated surgically

Aim: To assess the functional outcome of surgically treated Trimalleolar fractures by specific modalities to attain a proper anatomical alignment and stability of the ankle joint. Materials and Methods: The study was conducted in the Department of Orthopaedics, Sanjay Gandhi Institute of Trauma and Orthopaedics, Bangalore. This study consisted of 30 patients visiting the outpatient department and emergency department of the hospital. Patients diagnosed with Trimalleolar ankle fractures were included in the study who were operated on during the period between November 2019 and November 2020. The patients were followed up for 12 months. All the fractures in the study group were post-traumatic. Medical history, clinical examination and radiological examination were done, patients diagnosed with Trimalleolar ankle fractures are operated on as early as possible. At follow-up visits, the the patient is evaluated clinically (pain score, soft tissue status), radiologically (alignment, fracture reduction and union), and noted complications. Patients were evaluated with the American orthopedic foot and ankle society score (AOFAS) and the results were analyzed using descriptive statistics. Results: Excellent results were achieved in 7(23.33%), good in 21(70%) fair in 2 (6.66%) of patients cases. The patient with fair result had mild pain with activities of daily living, diminution in the abilities to run, reduced motion at the ankle. Conclusion: The size of the posterior malleolus fragment is not a clear indication for fixation or non-operative treatment of the posterior malleolus fragment. The anatomical intra-articular reduction of the fragment not leaving room for a step-off has far more impact on clinical outcome.