Short-Term Outcomes of Supination External Rotation IV Bimalleolar and Deltoid Variant Fractures With No Deltoid...

Area of Science:

• Orthopedic surgery
• Traumatology
• Radiology

Background:

• Supination-external rotation (SER) type IV ankle fractures present complex injury patterns.
• Management of associated deltoid ligament injuries without direct repair is a subject of ongoing investigation.
• The choice of fixation for the fibula, specifically universal tubular versus fibula-specific plates, may influence outcomes.

Purpose of the Study:

• To compare radiographic and clinical outcomes of SER type IV bimalleolar fractures versus deltoid ligament injuries treated without deltoid repair.
• To evaluate the effectiveness of universal tubular plates versus fibula-specific plates in fibular fixation for rotational ankle fractures.

Main Methods:

• Retrospective cohort study conducted at an academic medical center.
• Inclusion of skeletally mature patients with SER-IV ankle fractures (bimalleolar or deltoid variant).
• Radiographic outcomes (MCS, SCS, TFCS, talocrural angle, Takakura score) and clinical outcomes (complications, secondary surgeries, infections) were assessed.

Main Results:

• No significant demographic differences were observed between bimalleolar and deltoid-variant fracture groups.
• Radiographic alignment changes were comparable between bimalleolar fractures and deltoid ligament injuries treated without repair.
• While radiographic alignment changes differed between plate types, these were not clinically significant.

Conclusions:

• Fibular fixation alone for bimalleolar-equivalent injuries yields outcomes comparable to those with combined fixation.
• Deltoid ligament repair may not be necessary for restoring normal alignment in lateral malleolus fractures with medial deltoid injury.
• Both fibula-specific and universal tubular plates effectively maintain ankle fracture alignment.