Safety of Posterolateral Approach in High-Risk Patients with Trimalleolar Fractures

Abstract

Aim: Purpose of this study is to compare the outcomes of posterolateral approach (PLA) and minimal-invasive percutaneous anteroposterior (AP) approach for the fixation of posterior malleolar fragment in patients who have risk factors for wound healing. Material and Methods: 66 patients were analyzed in 2 study groups. Group 1: PLA (29 patients), Group 2: AP (37 patients). Patient demographics, risk factors for wound healing, presence of syndesmotic injury, fracture type, postoperative wound-healing complications and American Orthopedic Foot and Ankle Society ankle-hindfoot score (AOFAS) were recorded. Results: There was no difference between the study groups in regard to wound-healing problems. Obese and smokers had significantly more wound-healing problems regardless of the surgical approach. There was no statistically significant difference between the study groups in regard to AOFAS. Conclusion: In trimalleolar fractures, PLA can be safely considered even for the patients who have risk factors for wound-healing problems other than obesity and smoking.