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EVALUATION OF FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT IN DISPLACED CLOSED BIMALLIOLAR FRACTURES IN ADULTS
Doried Shaheen*, Ghiyas Halloum, Ezzat Almohamed
Objective: The aim of this study is to evaluate the functional outcome of the different surgical treatments of displaced closed bimalliolar fractures. In addition to, detection complications resulting from the surgery. Patients and Methods: Retrospective comparative study conducted for the period one year (May 2019 – May 2020) at Tishreen University Hospital in Lattakia-Syria. The study included two groups of patients were compared: group1 consisted of 30 patients (63.8%)who underwent fixation with tension wiring technique of the medial malleoli and with plate and screw of lateral malleoli, whereas group 2 consisted of 17 patients (36.2%) who underwent fixation by malleolar screw of medial malleoli and kirschner wires of the lateral malleoli. Results: The median age was 48 years, the most frequent age group was 51-65 year (44.7%), followed by the group 36-50 year ( 31.9%). Males represented 57.4 % of the patients, and right side was affected in 30 patients (63.8%). Low-energy injury was present in 40 patients (85.1%), and supination external rotation (SER) was the most frequent mechanism of injury (63.8%). Operative time was longer in group1( 70.96±5.9 vs47.94±6.2, p:0.0001). According to Baird Jackson scoring during follow up period, improvement in functional outcome was more prominent in group1 compared to group2. Sex(Male), and the type SER were significantly associated with excellent and good functional outcomes. Superficial skin necrosis and Sudeck's disease were the most frequent complications in group1, whereas secondary displacement, nonunion and chronic swelling were more frequently in group2. Conclusion: Functional outcome was better after fixation fractures in the form plating and screw of the lateral malleoli and tension wiring technique of the medial malleoli.[Full Text Article]