Nguyễn Văn Lượng, Nguyễn Năng Giỏi, Nguyễn Lâm Bình, Bùi Tuấn Anh, Hiếu Ngô Huy
Objective:To evaluate the clinical and imaging characteristics; and the outcomes of surgical treatment for closed posterior malleolar fractures using internal fixation.
Methods:A retrospective combined with prospective, cross-sectional descriptive study was conducted on 43 patients diagnosed with closed posterior malleolar fractures who underwent surgical treatment at Military Central Hospital 108, from September 2015 to June 2025. Outcomes were assessed using the AOFAS (American Orthopaedic Foot and Ankle Society) and VAS (Visual Analogue Scale) criteria, along with X-ray images.
Results:The mean age of the patients was 44.77 ± 16.04 years. The majority of patients were female (58.1%). The most common cause was traffic accidents (46.5%). The most frequent posterior malleolar fracture injury types were Weber B and AO/OTA type 44-B3 (both accounting for 51.2%). When categorized by Bartonicek, 42.9% of patients had type C posterior malleolar fractures, and 38.1% had type B fractures. The most commonly used fixation devices were cancellous screws (62.8%) and T-plates (23.3%). Short-term treatment outcomes showed that 100% of reductions were satisfactory. Long-term treatment outcomes showed that 100% of patients achieved very good or good bone union. Furthermore, 100% of patients achieved an AOFAS ankle score of 80 or higher. Post-operative pain level improved significantly, with 82.9% of patients reporting no pain sensation.
Conclusion: Surgical treatment of closed posterior malleolar fractures using internal fixation yields good treatment outcomes. Selecting the appropriate fixation device based on the injury morphology helps restore ankle joint function, limit complications, and enhance post-operative treatment efficacy.
