Single Oblique Posterolateral Approach for Open Reduction and Internal Fixation of Posterior Malleolar Fractures With an Associated Lateral Malleolar Fracture

• Published in: The Journal of foot and ankle surgery 2015-07, Vol.54 (4), p.559-564
• Main Authors: Choi, Jun Young, MD, Kim, Ji Hoon, MD, Ko, Hyeong Tak, MD, Suh, Jin Soo, MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Ankle Fractures - surgery; ankle joint; direct exposure; Female; Follow-Up Studies; Fracture Fixation, Internal - methods; Fracture Healing; Humans; Male; Middle Aged; Necrosis; Operative Time; Orthopedics; Postoperative Complications; Retrospective Studies; Skin - pathology; Sural Nerve - injuries; surgical approach; trimalleolar fracture
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2014.09.043

Abstract The purpose of the present retrospective study was to describe the single oblique posterolateral approach for open reduction and internal fixation of large, displaced, posterior malleolar fractures with an associated lateral malleolar fracture. A single oblique posterolateral approach was used for osteosynthesis of the posterior and lateral malleolus in 50 consecutive patients (23 females [46%], 27 males [54%]; mean age, 47.44 ± 16.13 years; mean follow-up duration, 26.32 ± 5.15 months). The mean interval to surgery was 4.3 ± 1.9 days after the inciting trauma. During the follow-up period, the surgery was complicated by skin necrosis around the incision in 2 (4%) patients and sural nerve damage in 2 (4%) patients. We found that the single oblique posterolateral approach to large, displaced, posterior malleolar fractures with an associated lateral malleolar fracture provided easy exposure of the posterior and lateral malleoli and had the potential to decrease the incidence of sural nerve injury because of the smaller incision size.