DOS 2017

174

· DOS Abstracts

Posterolateral approach to the ankle - early compli-

cations following ORIF. Early results from the PRO-

Malleol study

Catarina Malmberg, Peter Toft Tengberg, Ilija Ban, Morten Grove Thomsen,

Søren Kring, Mads Terndrup

Department of Orthopaediac Surgery, Copenhagen University Hospital, Hvi-

dovre; Department of Orthopaediac Surgery, Copenhagen University Hospital,

Hvidovre; Department of Orthopaediac Surgery, Copenhagen University Hos-

pital, Hvidovre; Department of Orthopaediac Surgery, Copenhagen University

Hospital, Hvidovre; Department of Orthopaediac Surgery, Copenhagen Univer-

sity Hospital, Hvidovre; Department of Orthopaediac Surgery, Copenhagen Uni-

versity Hospital, Hvidovre

Background:

The posterolateral approach to the distal tibia is reported to be

safe, allowing anatomical reduction of posterior malleolar fractures improving

outcome

Purpose / Aim of Study:

To examine postoperative complications within the

first 3 months following posterior fragment fixation using variable angle locking

plates (VA-LCP) through the posterolateral approach

Materials and Methods:

Adult patients with trimalleolar fractures treated with

variable angle plate fixation of the posterior fragment through a posterolateral

approach, as dictated by a standardized algorithm in our clinic, were included

prospectively from June 2016 to January 2017. Radiological and clinical follow-

up was performed in a dedicated ankle fracture out-patient clinic as part of the

“PRO-Malleol Algorithm study” (clinicaltrials NCT03107767)

Findings / Results:

42 patients with mean age 55y (range 26-79) were in-

cluded. Thirty patients had AO/OTA fracture type 44B3, and twelve 44C-type

(8C1, 3C2, 1C3). 71% of patients were allowed full weight bearing from day

one. Two patients had severe complications, one requiring reoperation due to

deep infection and one patient suffered severe pain with suspected complex

regional pain syndrome. Two patients had superficial wound infection requiring

only oral antibiotics. Five patients had superficial wound problems/minor de-

fects without infection, which were managed with conservative treatment in

the out-patient clinic and all healed. There were no cases of thromboembolic

events

Conclusions:

Complications were seen in 21% of patients, 4.7% having severe

complications requiring either reoperation, readmission to hospital or with se-

vere impairment of everyday life 3 months after surgery. We believe that the

posterolateral approach is safe and that a severe early complication rate <5%

can be tolerated for patients with complex trimalleolar fractures

No conflicts of interest reported

126.