POSTERIOR VERSUS LATERAL PLATING FOR LATERAL MALLEOLUS FRACTURES USING A POSTEROLATERAL APPROACH-A CLINICAL STUDY

Abstract

Background: Lateral malleolus fractures are the most frequently recorded ankle injuries. Most cases require operative fixation to restore optimal ankle mobility. Traditionally, lateral plating has been used to treat these kinds of injuries; however, problems related to implant prominence and soft-tissue complications have been reported. Recently, the posterolateral approach has emerged as an alternative technique with potential biomechanical and clinical advantages. The current study aimed to determine the posterior plating and lateral plating of lateral malleolus fractures using a posterolateral approach. Methods: This prospective comparative clinical study was done in the department of orthopedics on 30 cases of displaced lateral malleolus fractures. They were allocated into two groups of (n=15) each. Group A received posterior plating, and Group B cases were treated by lateral plating. The surgical method in both cases was a posterolateral approach. Comparison of operative time, fluoroscopy time, radiological union, functional outcome using Olerud–Molander Ankle Score (OMAS), and complications was evaluated. All the cases were followed up for 6 months. Results: Groups were comparable in terms of baseline characteristics, showing homogeneous distribution. The operative time was longer in posterior plating, and fluoroscopy time was lower in this group, with p-values showing significance. The overall radiological outcome, hospital stay, and time to full weight bearing were found to be similar in both groups. Functional outcomes were found to be significantly better in the posterior plating group, with higher mean OMAS scores, and minimal complications were recorded. Group B showed cases of implant irritation, and the need for implant removal was higher in this group compared to Group A. Conclusion: The present study concluded that the posterior approach with posterior plating for displaced lateral malleolus fractures was superior compared to lateral plating with fewer complications and comparable radiological results. Therefore, this method should be preferred in feasible cases.