Sistema Ortopédico e Muscular: Pesquisa Atual
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Lateral Malleolus Hook-Plate Fixation in the Treatment of Herscovici Type B Medial Malleolar Fractures: The Clinical Evaluation of an Alternative Fixation Technique

Kai Xiao*, Zhen-hua Fang and Cheng Hao

Background: To evaluate the availability of lateral malleolus hook plate fixation for medial malleolar fractures.
Materials and Methods: 23 patients with Herscovici type B medial malleolar fractures were involved as subjects between January 2013 and December 2015. All the patients had undergone lateral malleolus hook plate fixation surgery. 6 males and 17 females with an average age of 46.0 ± 12.4 years (range, 22-62 years) were identified. All of the fractures were evaluated based on Herscovici medial malleolar fractures classification. Postoperatively, radiographs was used to assess the quality of bone union directly at the follow-up examination. The clinical evaluation was based on the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system.
Results: 21 patients had adequate follow-up for clinic evaluation. The mean follow-up period was 18.6 ± 4.2 months (range; 13–28 months). Full union was achieved in all fractures with mean time of 12.9 ± 2.03 weeks (range, 10-16 weeks). The mean AOFAS score was 94.1 ± 4.4 (range; 87–100) at final follow up. The mean range of injured ankle plantar flexion and dorsi flexion motion were 40.6 ± 2.8 (range; 35–45) and 15.4 ± 2.7 (range; 10–20) respectively in post-operation at final follow up. The injured ankle motion presented good rehabilitation. Based on AOFAS evaluation standard, the outcome was excellent in 18 cases and good in 3 cases.
Conclusion: In this study, lateral malleolus hook-plate fixation yielded good clinical outcome in surgical treatment of Herscovici type B fractures.