[Diagnosis and surgical treatment of posterior collicular fracture of medial malleolus].
OBJECTIVE
To summary the diagnosis and surgical treatment experiences of posterior collicular fracture of medial malleolus.


METHODS
Between March 2008 and November 2010, 14 patients having lateral and (or) posterior malleolus fractures with posterior collicular fracture of medial malleolus were treated with open reduction and internal fixation, including 5 males and 9 females with an average age of 44.5 years (range, 27-60 years). The causes of injuries were strain in 9 cases, traffic accident in 3 cases, and falling from height in 2 cases. The course of fracture ranged from 3 to 9 days (mean, 6.5 days). Fourteen cases were lateral malleolus fractures, 10 cases were posterior malleolus fractures. According to Lauge-Hansen classification, there were 8 cases of pronation-external rotation type, 3 cases of pronation-abduction type, and 3 cases of supination-external rotation type.


RESULTS
All incisions healed by first intention with no complication. The patients were followed up 12-24 months (mean, 16.8 months). The X-ray films showed that all fractures healed from 2 to 4 months after operation (mean, 2.9 months). The range of motion (ROM) of affected ankles was (38.40 +/- 3.50) degrees of flexion and was (16.30 +/- 2.41)degrees of extension, showing no significant difference when compared with ROM of normal side [(40.50 +/- 3.48)degrees and (17.90 +/- 2.28) degrees, P > 0.05]. All patients' ankle function was evaluated by Olerud-Molander's score criteria for ankle function evaluation, the results were excellent in 7 cases, good in 6 cases, and fair in 1 case.


CONCLUSIONS
Spiral CT plays an indispensable role in diagnosis of posterior collicular fracture of medial malleolus. Surgical reduction and rigid fixation should be performed.
Fourth Department of Trauma, Second Hospital of Tangshan, Tangshan Hebei 063000, PR China. wanglei2003814@163.com
Lei
L
Wang
Zhixin
Z
Wu
Xin
X
Liu
D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome