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- Talk
- 21/09/2021
- UK
Outcomes of Posterior Malleolar Fixation in Adult Ankle Fractures in a Major Trauma Centre
Description
This presentation, delivered by Nelson Bua, a registrar in training from London, focuses on patient-related outcomes in individuals with posterior malleolar fractures as part of ankle fractures, based on a study conducted at the Royal London Hospital from 2012 to 2018. The session begins with an overview of the significance of posterior malleolar fractures, detailing that historically, such fractures were associated with poor outcomes in comparison to uni- and bimalleolar fractures. The decision-making around fixation of these fractures is emphasized as still being a subject of debate among trauma professionals. The presentation highlights the evolution of understanding regarding ankle biomechanics, particularly the role of the posterior fibulotalar ligament and the malleolar fragment itself in stabilizing the ankle joint.
Bua outlines a retrospective study involving 320 patients above the age of 18, where data including medical records, follow-up, and imaging were thoroughly analyzed to compare outcomes based on fixation methods. The findings indicate that patients who had their posterior malleoli fixed showed better outcomes as evidenced by the Manchester-Oxford Foot Questionnaire despite a higher overall complication rate, particularly associated with hardware issues.
As the talk progresses, various questions arise from the audience regarding surgical methods, outcomes by fracture classification, and the implications of different fixation techniques (antiglide plates versus AP screws). Bua goes on to discuss the complications noted in the study, including hardware removal and reoperation due to syndesmosis malreduction. The presentation concludes with the assertion that, while fixation appears to yield better clinical outcomes for patients, it is accompanied by an increased rate of complications.