Ankle fractures. A clinical and roentgenographic stereophotogrammetric study

To analyze postoperative fracture stability and late ankle mortise mobility, 46 lateral malleolar and 53 bimalleolar ankle fractures were randomly separated to either early or late weight-bearing groups and followed for 18 months. Internal fixation with cerclage wires, staples, and pins were used. Better clinical results were found among the lateral malleolar compared with the bimalleolar fractures. Roentgenographic stereophotogrammetric analysis revealed only small movements in the ankle mortise during fracture healing, although a greater dorsal translation and outward rotation of the fibula were found among the pronation injuries compared with the supination injuries. The repair of a ruptured deltoid ligament was not necessary. An increased rigidity of the ankle mortise was found 18 months after injury. Internal fixation with cerclage wires, staples, and pins is a simple and reliable method that provides sufficient stability to allow immediate postoperative weight bearing in a walking cast for most ankle fractures.