[Surgical techniques of open reduction and internal fixation for ankle fracture]

To evaluate the surgical techniques of open reduction and internal fixation performed for ankle fracture retrospectively and the corresponding clinical outcomes.

From March 2001 to January 2006, 242 patients with ankle fracture were treated. A total of 85 patients with complete clinical data were analyzed. According to the Lauge-Hansen classification system, the fractures were classified into pronation-external rotation (grade II) in 12 cases and grade IV in 9 cases, supination-external rotation (grade II) in 34 cases and grade IV in 16 cases, supination-adduction (grade II) in 8 cases, and pronation-abduction in 6 cases. The reduction and internal fixation started with lateral malleolus, then medial malleolus and posterior malleolus, and distal tibiofibular syndesmosis in sequence. Among 10 cases, 5 of the distal tibiofibular syndesmosis were fixed with one screw through 3 layers of bone cortexes. All cases were auxiliarily fixed with plaster pad for 4 to 6 weeks after operation.

The follow-up period varied from 6 to 36 months, with an average of 10 months. There were no local complications such as malunion or nonunion of the fractures and deformity of the ankle. The inserted screw to distal tibiofibular syndesmosis was not broken. The patients were evaluated with Baird-Jackson scoring system. The numbers of the patients who had excellent, good, fair and poor results were 53, 23, 6, 3, respectively. The excellent and good rate was 89.4%.

Operative treatment may provide satisfactory clinnical outcomes for ankle fracture. Proper internal fixation and correct fracture pattern estimation are of importance to achieve and gain better long-term results.