Fragment-Specific Fixation for Trimalleolar Fractures: Functional and Radiological Outcomes

Introduction A trimalleolar fracture is a complex unstable fracture that usually occurs as the result of rotational injuries of the ankle. Management and understanding of these fractures have evolved greatly over the last decade. Our study aimed to assess the postoperative outcomes following the fixation of these fractures using fragment-specific low profile anatomical fixation implants. Methods We retrospectively analyzed patients admitted to our multidisciplinary team unit with a trimalleolar fracture between October 2021 and February 2024. Each fracture was classified using CT imaging and subsequently fixed using fragment-specific implantation (Volition^TM). In the postoperative period, patients were followed up and assessed functionally and radiologically. Results A total of 40 skeletally mature patients were included in this study, each requiring surgical fixation for a tri-malleolar ankle fracture. Patient-reported outcome data collected showed an average Manchester-Oxford Foot Questionnaire (MOXFQ) score of 34.3 (±24.6) and a Foot and Ankle Disability Index (FADI) score of 77.9 (±22.1). All but one fracture successfully achieved radiological union with a mean time to union of 7.4 weeks (5-16 weeks). Conclusions Our study is an early demonstration of the promising results that can be observed through the use of fragment-specific low-profile anatomical fixation. Further comparative studies would provide a further understanding of the effectiveness.