TRIMALLEOLARFRACTURES :- FRAGMENT SPECIFIC FIXATION AND ITS FUNCTIONAL OUTCOMES

Trimalleolar fractures are disabling injuries if not managed properly. Clinical and functional outcomes oftrimalleolar fracture are worse as compared to bimalleolar fractures not involving the posterior malleolus. Various surgical approaches and techniques to reduce and fix these fractures described in the literature.In this case study of 11 patients with trimalleolar fractures, a posterolateral approach was used for fixation of posterior malleolus as well as lateral malleolus in all the cases. A preoperative CT scan was done in all the cases. The Olerud and Molendar scoring system was used to assess the functional outcome.The average age of patients was 52.6 years. The most common mode of sustaining injury was twisting of the ankle joint (n = 7). The average time to union and full weight-bearing was 12 weeks (range 10–14 weeks). An excellent functional outcome in 6 patients and a good outcome in 5 patients were obtained at the end of 12 months of follow-up. No significant complications were encountered. The posterolateral approach provides good exposure to fix both posterior and lateral malleolus via single incision. Stable fixation of posterior malleolus plays a vital role in obtaining good clinical and functional outcomes.