Study of clinical outcome in posterior plating for fibula in bimalleolarfracture ankle

Introduction: The anatomy of the joint makes it very unstable in cases of fractures or ligamentous injuries of the ankle, because the whole body weight is transmitted through the ankle and locomotion depends upon the stability of the ankle joint. In the post-operative period, the protocol of mobilization of the ankle has been a topic of conflict. The goals of treatment include achieving sound union of fracture and an ankle that moves and functions normally without pain. Materials and Methods: This is prospective consecutive case series of 60 patients of bimalleolar ankle fracture, undergone internal fixation in the form of plate fixation over posterior surface of fibula for lateral malleolus and cancellous screw fixation for medial malleolus. Data collection was done using history sheet, clinical examination, and radiological examination at intervals while functional outcome was assessed at follow up visits using Weber's assessment protocol. Results: 50 (83.3%) cases radiological union is achieved by 6 weeks while 10(16.7%) cases union time was 10 weeks. Average time for union was 6.7 weeks. The final outcome as per the Weber's assessment protocol was 50% as excellent, 40% as good and 10% as poor result which showed good correlation with level of reduction achieved graded from immediate post-operative radiographs. Conclusion: Accuracy of reduction and rigid fixation was found to be a major determinant of functional outcome irrespective of the type of fracture. Posterior plate fixation gives bicortical screw purchase leading to secure fixation, no intra- articular penetration, decreased complications, hardware prominence and wound dehiscence.