Summary. The number of mistakes and complications in the diagnostics and treatment of malleolus fractures is still significant. Objective. The retrospective analysis of mistakes and complications in the diagnostics and treatment of malleolus fractures. Materials and Methods. 385 patients with consequences of malleolus fractures (AO/OTA 44) from March 2000 to August 2020. There were 280 men and 105 women aged 18-87 years. The time from the injury was 3–408 months (on average 29.9±6.8 months). The analysis was carried out according to the recommendations of AO and AUPO “Ukrainian Association of Orthopedists-Traumatologists”. Results. Mistakes in the diagnosis and treatment amounted to 57.4% (221 cases); in 164 cases (42.6%) the severity of initial trauma and the time from the injury were objective factors for the development of deforming arthrosis of stages 3-4. Diagnostic defects took place in 40 cases (10.4%). The unproved conservative treatment was used in 47 cases (12.2%). Defects in surgical technique were noted in 174 cases (45.2%): failure to perform osteosynthesis of the fibula in “С” fractures – 24 cases (6.2%), improper surgical approach – 45 cases (11.7%), improper fixator choice – 45 cases (11.7%), transcutaneous wire fixation as the main osteosynthesis – 14 cases (3.6%), and improper tibiofibular stabilization – 49 cases (12.7%). Malreduction of broken bones in operated on patients was registered in 114 cases. Conclusions. Our results may be useful at the planning of future clinical and epidemiological investigations.
Thur C, Edgren G, Jansson K, Wretenberg P. Epidemiology of adult ankle fractures in Sweden between 1987 and 2004: a population-based study of 91,410 Swedish inpatients. Acta Orthop. 2012;83(3):276-81. doi: 10.3109/17453674.2012.672091.
Elsoe F, Ostgaard SE, Larsen P. Population-based epidemiology of 9767 ankle fractures. Foot and Ankle Surgery. 2017;24(1):34-9. doi:10.1016/j.fas.2016.11.002.
Hasselman CT, Vogt MT, Stone KL, Cauley JA, Conti SF. Foot and ankle fractures in elderly white women. Incidence and risk factors. J Bone Joint Surg (Am). 2003;85(5):820-4. doi: 10.2106/00004623-200305000-00008.
Kannus P, Palvanen M, Niemi S, Parkkari J, Jarvinen M. Increasing number and incidence of low-trauma ankle fractures in elderly people: Finnish statistics during 1970–2000 and projections for the future. Bone. 2002;31(3):430-3.
Valderrabano V, Horisberger M, Russell I, Dougall H, Hintermann B. Etiology of ankle osteoarthritis. Clin Orthop. 2009;467(7):1800-1806. doi: 10.1007/s11999-008-0543-6.
Horisberger M, Valderrabano V, Hintermann B. Posttraumatic ankle osteoarthritis after ankle-related fractures. J Orthop Trauma. 2009;23(1):60-67. doi: 10.1097/BOT.0b013e31818915d9.
Beris AE, Kabbani KT, Xenakis TA, Mitsionis G, Soucacos PK, Soucacos PN. Surgical treatment of malleolar fractures. A review of 144 patients. Clin Orthop. 1997;341:90-98. PMID: 9269160.
Lübbeke A, Salvo D, Stern R, Hoffmeyer P, Holzer N, Assal M. Risk factors for post-traumatic osteoarthritis of the ankle: an eighteen year follow-up study. Internat Orthop (SICOT). 2012;36:1403-1410. DOI 10.1007/s00264-011-1472-7.
Салихов Р.З., Панков И.О., Плаксейчук Ю.А., Соловьев В.В. Ошибки и осложнения при лечении сложных переломов области голеностопного сустава. Практическая медицина. 2014;2(4):128-131. Salikhov RZ, Pankov IO, Plakseychuk YuA, Solovyev VV. Errors and complications in the treatment of complex ankle fractures. Practical medicine. 2014;2(4):128-131. (in Russian).
Whitehouse S, Mason LW, Jayatilaka L, Molloy AP. Fixation of ankle fractures – a major trauma centre’s experience in improving quality. Ann R Coll Surg Engl. 2018;101:387-390. DOI:10.1308/rcsann.2018.0098.
Ovaska MT, Mäkinen TJ, Madanat R, Kiljunen V, Lindahl J. A comprehensive analysis of patients with malreduced ankle fractures undergoing re-operation. Internat Orthop (SICOT). 2014;38(1):83-88. DOI:10.1007/s00264-013-2168-y.
Stufkens SA, van den Bekerom MPJ, Doornberg JN, van Dijk CN, Kloen P. Evidence-based treatment of maisonneuve fractures. J Foot Ankle Surg. 2011;50(1):62-7. doi:10.1053/j.jfas.2010.08.017.
Pelton K, Thordarson DB, Barnwell J. Open versus closed treatment of the fibula in Maissoneuve injuries. Foot Ankle Int. 2010;31(7):604-8. doi:10.3113/FAI.2010.0604.
Putnam SM, Linn MS, Spraggs-Hughes A, McAndrew CM, Ricci WM, Gardner MJ. Simulating clamp placement across the trans-syndesmotic angle of the ankle to minimize malreduction: a radiological study. Injury. 2017; 48(3):770-775. doi:10.1016/j.injury.2017.01.029.
This work is licensed under a Creative Commons Attribution 4.0 International License.