Introduction

Bimalleolar fractures represent 9% of fractures and affect 187/100,000 people per year. The gold standard for osteosynthesis is a one-third tubular or lateral locking plate and compression screwing or use of tension band wiring, with complete weight bearing planned around the 6th week. The development of locking plates seems to allow earlier resumption of weight bearing. The objective of our study was to evaluate the clinical and radiological results after internal fixation of bimalleolar fractures using locking plates with complete weight bearing authorized from the outset. The hypothesis was that this does not predispose to cutaneous or mechanical complications.

Hardware and method

A continuous multi-operator retrospective study was performed. The clinical and radiological data of 55 patients operated on for bimalleolar fractures were collected. All underwent osteosynthesis with medial and lateral locking plates with authorization for weight bearing from the outset.

Results

Complete weight bearing was resumed at 27.4 days 14.7 [7–60] postoperatively. No non-union or malunion was found. Two patients presented with delayed medial healing without the need for hardware removal. Two patients required removal of the lateral Plate 1 month postoperatively due to infection. Seven patients presented with discomfort related to hardware, justifying its removal at 1 year. The Kitaoka score at 1 year was 94.6 7.7 [71-100].

Conclusion

The use of medial and lateral locking plates in bimalleolar fractures associated with complete weight bearing authorized from the outset allows complete consolidation. There was no increase in cutaneous or mechanical complications.

Level of evidence

IV, retrospective study.

中文翻译：

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锁定钢板固定双踝骨折后完全负重恢复

介绍

双踝骨折占骨折的 9%，每年影响 187/100,000 人。接骨术的金标准是三分之一管状或侧向锁定板和加压螺钉或使用张力带布线，计划在第 6 周左右完全负重。锁定板的发展似乎允许更早地恢复负重。我们研究的目的是评估从一开始就批准使用完全承重的锁定钢板内固定双踝骨折后的临床和放射学结果。假设是这不会导致皮肤或机械并发症。

硬件和方法

进行了一项连续的多操作者回顾性研究。收集了 55 例双踝骨折手术患者的临床和放射学资料。所有患者均接受了内侧和外侧锁定板的接骨术，并从一开始就获得了负重许可。

结果

术后 27.4 天 14.7 [7–60] 恢复完全负重。未发现不愈合或畸形愈合。两名患者出现内侧愈合延迟而无需移除内固定。两名患者因感染需要在术后 1 个月取出侧板。七名患者出现与硬件相关的不适，证明其在 1 年时移除是合理的。1 年时的北冈得分为 94.6 7.7 [71-100]。

结论

在从一开始就授权完全负重的双踝骨折中使用内侧和外侧锁定钢板可以实现完全巩固。皮肤或机械并发症没有增加。

证据等级

四、回顾性研究。