Surgical Management of Posterior Malleolar Fractures Using the Direct or Indirect Reduction Techniques

The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School148 enrolled

Overview

Patients with a posterior malleolar fracture were recruited and assigned to the direct reduction (DR) group or the indirect reduction (IR) group. Following reduction and fixation of the fracture, the quality of fracture reduction was evaluated in radiograph and CT images. Functional outcome was evaluated at the last follow-up.

Patients with a posterior malleolus fracture were recruited meeting the inclusion criteria of unstable and displaced posterior malleolar fractures requiring surgical management. Patients with open fractures or pathological fractures were excluded. Preoperative anteroposterior (AP), lateral, and mortise view radiographs as well as computed tomography (CT) scans were routinely obtained to evaluate the characteristic of the fracture. Patients were then assigned to the direct reduction (DR) group or the indirect reduction (IR) group. Following reduction and fixation of the fracture using the direct reduction technique or the indirect reduction technique, the quality of fracture reduction was evaluated in radiograph and CT images. Functional outcome,including AOFAS score, ankle range of motion were evaluated at the last follow-up.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

148

Conditions

Posterior Malleolus Fractures

Interventions

direct fracture reduction and fixationPROCEDURE

In the DR group, the posterior malleolar fracture was reduced and fixed in a direct way via a posterolateral approach with the patients in prone position.

indirect fracture reduction and fixationPROCEDURE

In the IR group, the posterior malleolus was reduced through ligamentotaxis following open reduction and internal fixation of lateral and medial malleolar fractures. Percutaneous cannulated screws were used to fix the posterior malleolar in anterior-to-posterior direction.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * unstable ankle fracture requiring surgical intervention * with posterior malleolar fracture Exclusion Criteria: * open fractures * pathological fractures

Locations (1)

Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School

Nanjing, Jiangsu, China

Outcomes

Primary Outcomes

American Orthopaedic Foot and Ankle Society ankle-hindfoot score

Time frame: 1 year

Secondary Outcomes

ankle range of motion in degrees

Time frame: 1 year

residual displacement of the posterior malleolus in mm

Time frame: 3 days postoperatively

Data from ClinicalTrials.gov

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