Surgical treatment of malleolar fractures. A review of 144 patients.

Malleolar fractures are one of the most common fractures faced in orthopaedic surgery. The results from a consecutive series of 144 malleolar fractures during a 10-year period that were classified and treated according to the AO system are presented. Assessment of outcome was done using the scoring system of Baird and Jackson, which is based on subjective, objective, and radiographic criteria. Excellent and good results were achieved in 107 of the 144 patients surgically treated. Overall, excellent and good results were obtained in almost all unimalleolar fractures, but were significantly less in bimalleolar fractures. There was no difference in outcome achieved between Weber C and Weber D fractures. The presence of a large bony fragment or dislocation also significantly affected the final outcome. Posttraumatic osteoarthritis was found to be associated significantly with poor clinical results, bimalleolar fractures, and unsatisfactory surgical reduction.