Transfibular Approach in Treating Malunited Ankle Fracture

Category: Trauma; Ankle Introduction/Purpose: The surgical treatment of malunited ankle fracture is challenging. This study investigated the results of reconstruction for malunited ankle fracture involving lateral and posterior malleolus via transfibular approach. Methods: Between Jan 2015 and Feb 2017, 10 patients underwent reconstruction surgeries for malunited ankle fracture involving lateral and posterior malleolus were followed up. All the ten surgeries were performed via transfibular approach. The mean final follow-up was 26.2 months (range 24–36). American Orthopaedic Foot and Ankle Society (AOFAS)score, Visual Analogue Scale (VAS) for pain, and patients’ subjective satisfaction were used to measure clinical outcomes. Results: The mean AOFAS-AH score and VAS score improved from 43±10.7 to 79±7.8 points (p < 0.05), 6.7±1.0 to 2.0±1.2 points (p < 0.05), respectively. Five patients rated the result as excellent, 4 as good and 1 as fair. Conclusion: The transfibular approach can expose and reduce both the posterior and lateral malleolar malunion with minimal additional soft tissue disruption. It is a useful method to correct the malunited ankle fracture involving lateral and posterior malleolus.