Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Introduction: Ankle fractures are common, with an incidence of up to 174 cases per 100,000 adults per year. Their correct classification and treatment are of decisive importance for clinical outcome. The important facts about malleolar fractures are: They are intra-articular injuries. Soft-tissue injury is common as the bones are subcutaneous. Uni malleolar fractures are the most common (68%) followed by bi malleolar fractures (25%) and tri malleolar fractures (7%). Medial malleolus fractures have traditionally been managed using partially threaded screws and/or Kirschner wire fixation. Using these conventional techniques, a non-union rate of as high as 20% has been reported method suggesting better outcome has been described using 2hook Plates3. Patients and methods: 25 patients with mean age of 37.16 presented to orthopedic surgery department with Supination adduction (vertical shear) fracture. All patients were treated by open reduction and internal fixation of medial malleolus by a hook plate. Patients were assessed by the foot and ankle society score (AOFAS) at 2, 4 and 6 months. Results: We achieved union in 96% of all 25 cases with progressive (AOFAS) improved over time. Complications included 20% of all cases. Conclusions: Our results compares with results of Chen Y et al and Kai Xiao et al regarding joint reduction, stable fixation, minimal complications, and functional outcome when treating Supination adduction (vertical shear) fracture of the medial malleolus

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