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Category: Volume 06 Issue 12 December 2018
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Title: Evaluation of Functional outcomes in Bimalleolar Fractures Treated with CCS and DFALP

Authors: Dr Anurag Jain, Dr Divyesh Limbasiya, Dr Sonal Lakum, Dr Anirudh Bansal, Dr Sudhir Rawat, Dr Arvind Kumar*, Dr Ravi Kumar

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.88

Abstract

Introduction: ​Bimalleolar fractures are very common in ankle injuries because of increased incidence of road traffic accidents and industrial trauma. Anatomical reduction and stable internal fixation is important for good outcomes. ​

Aim & Objectives:​ To study functional outcomes of Bimalleolar fracture treated with CCS and DFALP; To achieve anatomical/near anatomical fracture reduction, stable internal fixation and early mobilization of the ankle.

Materials​ and Methods: We have evaluated functional and radiological outcomes of 20 patients treated with closed / open reduction with internal fixation used Cannulated Cancellous Screw (CCS) for medial malleolus and Distal Fibular

Anatomical Locking Plate (DFALP) for Lat malleolus .Lauge Hansens classification was used for fracture evaluation. ​Baird and Jackson Scoring system was used to evaluate functional ​outcomes.

Results: In this prospective study, 20 cases of Bimalleolar fractures of ankle were selected by exclusion and inclusion criteria and treated with CCS and DFALP. Most common mode of injury was supination external rotation injury accounts for 45 % (9 cases). All cases were treated surgically with closed / open reduction with internal fixation. All cases of medial malleoli fracture were treated with cannulated cancellous screw and all cases of lateral malleoli fractures were treated with distal fibular anatomical locking plate by minimally invasive procedures. We found excellent results in 55% (11 cases), good results 25% (5 cases), fair results in 15% (3 cases) and poor result in 5% (1 case). ​

Conclusion: ​In this study, after analysing our functional and radiological outcomes and has been compared with other published result and found that Cannulated Cancellous Screws (CCS) and distal fibular anatomical locking plate (DFALP) give excellent results. From this study it is concluded that CCS and DFALP are the good implants and ideal treatment modalities for Bimalleolar fracture of ankle. 

Level 1 evidence: Prospective study

Keywords: Bimalleolar fracture, CCS, DFALP, SER.

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Corresponding Author

Dr Arvind Kumar

Associate Professor & Unit Head, Department of Orthopaedic, Sumandeep Vidyapith University