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Operative treatment of displaced lateral malleolar fractures: the Knowles pin technique
Yih-Shiunn Lee1, Chun-Chen Huang, Cheng-Nan Chen
1Department of Orthopedic Surgery, Taipei Municipal HoPing Hospital, Taipei, Taiwan.
Objectives:
To assess the use of Knowles pin fixation for isolated displaced lateral malleolar fractures and to present our surgical experience using this method.
Design:
Retrospective evaluation.
Setting:
The study was carried out at a municipal teaching hospital. The senior surgeons were all orthopedic trauma subspecialists.
Patients:
A total of 168 patients meeting our inclusion criteria, an isolated displaced lateral malleolar fracture surgically treated by a Knowles pin between 1995 and 2000, were studied. All the patients had a stable syndesmosis, less than 50% comminution, and had no other operations in the same extremity. Patients were assigned into 4 groups according to the Orthopedic Trauma Association classification of ankle fractures.
Intervention:
Open reduction and internal fixation with a Knowles pin fixation of the lateral malleolus.
Main Outcome Measurements:
Functional results were evaluated using the Baird and Jackson ankle scoring system.
Results:
There was a 100% union rate. The average satisfactory outcome of the 4 groups was 88.1%. No instrumentation problems were encountered. Three complications occurred, but resolved with nonoperative therapy.
Conclusions:
Knowles pin fixation for displaced lateral malleolar fractures is a useful and effective method. This implant offers several advantages, including easy application, less soft tissue dissection, less palpable instrumentation, stable fixation, and a short operating time.
