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European Journal of Orthopaedic Surgery & Traumatology

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01-08-2019 | Original Article • ANKLE - FRACTURES

Negative prognostic factors in surgical treatment for trimalleolar fractures

Authors: Gianluca Testa, Marco Ganci, Mirko Amico, Giacomo Papotto, Serena Maria Chiara Giardina, Giuseppe Sessa, Vito Pavone

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 6/2019

Abstract

Purpose

Trimalleolar fractures are a common injury of the ankle that require surgical treatment to obtain an anatomic reduction of both malleoli and stabilization of the syndesmosis. This study aims to report the outcomes of surgical treatment for trimalleolar fractures, identifying the risk factors determining a worse result.

Materials and methods

Between January 2013 and December 2016, 48 patients with trimalleolar fracture treated with open reduction and internal fixation were retrospectively analyzed. The mean age was 44.69 years, and average body mass index (BMI) was 29.04. According to the Danis–Weber classification, 30 (62.5%) fractures were type B and 18 (37.5%) were type C. Clinical and radiographic evaluations at 3, 6, and 12 months were assessed. The functional results of Visual Analogue Staircases and Olerud–Molander (O&M) ankle score were reported.

Results

No significant difference was found among the size of the PM in patients with and without ankle dislocation (p = 0.364). Therefore, there is no correlation between the size of the posterior fragment and the ankle dislocation and the size of the posterior malleolus and syndesmosis stability (p = 0.328). Age over 61 years, BMI > 40, ASA > 1, type C fracture, and fracture dislocation were considered as negative prognostic fractures.

Conclusions

Surgical treatment for trimalleolar fractures needs accurate preoperative planning. Age over 61 years, BMI > 40, ASA > 1, type C fracture, and fracture dislocation were considered as negative prognostic fractures.

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Title: Negative prognostic factors in surgical treatment for trimalleolar fractures
Authors: Gianluca Testa
Marco Ganci
Mirko Amico
Giacomo Papotto
Serena Maria Chiara Giardina
Giuseppe Sessa
Vito Pavone
Publication date: 01-08-2019
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 6/2019
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-019-02430-6

At a glance: The STEP trials

Springer Medicine

Negative prognostic factors in surgical treatment for trimalleolar fractures

Abstract

Purpose

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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