• 대한관절경학회지
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• 제2권1호
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• pp.93-96
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• 1998

We treated 10 cases of the medial malleolar fracture of the ankle by open reduction and internal fixation from June 1997 to December 1997. After the rigid internal fixation, we measured the gap of the fracture site and the step off of the articular surface by special instrument under the ankle arthroscopy whether it was reduced anatomically or not. And we tried to know the necessity of the arthroscopically assisted reduction and fixation in the medial malleolar fracture of the ankle. Under the arthroscopic view, all 10 cases were anatomically reduced as less than 1 mm of gap of the fracture site and less than 1mm of step off of the articular surface after open reduction and internal fixation in the medial malleolar fractures. In conclusion, through the arthroscopic management, it has advantage in finding and treating the accompanying intraarticular lesion, but also has disadvantage in setting the arthroscope and prolonging the operation time.

• 대한족부족관절학회지
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• 제15권1호
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• pp.36-38
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• 2011

Ankle fracture and Achilles tendon rupture are common as an isolated injury. However, Achilles tendon rupture with ipsilateral ankle fracture is uncommon, and occurs by a different injury mechanism with a risk of negligence. We report a case of Achilles tendon rupture with ipsilateral medial malleolar fracture.

• 대한족부족관절학회지
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• 제14권1호
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• pp.84-89
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• 2010

Purpose: The purpose of this study is to evaluate the clinical and radiologic results of using Acutrak screws for treating ankle medial malleolar fracture. Materials and Methods: We reviewed 38 cases of ankle medial malleolar fracture treated with Acutrak screws from February 2005 to May 2008. Results: In clinical result, there were 30 exellent cases, 7 good cases, 1 fair case. In radiologic result, there is no case with reduction loss. Average union time is 10.5 weeks. Conclusion: We conclude that Acutrak screw fixation is a useful method for ankle medial malleolar fracture, there are many advantages in accurate anatomical reduction, small incision, short operative time.

• 대한족부족관절학회지
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• 제6권1호
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• pp.54-59
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• 2002

Purpose: To compare the clinical results between the screw fixation and modified tension band wiring in the treatment of medial malleolar fracture. Materials and Methods: From September 1998 to April 2002, 52 patients were treated by screw fixation and 43 patients were treated by modified tension band wiring for medial malleolar fracture. Results: Accoding to Lauge- Hansen classification, there were 28 cases of supination-external rotation type (53.8%), 9 of supination-adduction type (17.3%), 8 of pronation -external rotation type (15.4 %), 7 of pronation -abduction type (13.5 %) in screw fixation group and 21 (48.9%),11 (25.6%), 7 (16.3%) 4 (9.3%) of each type in tension band wiring group. The average time to union was 15.7 weeks in screw fixation group and 12.8 weeks in tension band wiring group.(p<0.05) In the functional outcome (according to Meyer and Kumler), 29 patients treated (76.2 %) with screw fixation showed excellent results and 34 patients (86.6%) treated with tension band wiring had excellent results (p<0.05). Conclusion: We concluded that more satisfactory result could be obtained with modified tension band wiring compared with screw fixation in the treatment of the medial malleolar fracture.

• 대한족부족관절학회지
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• 제5권2호
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• pp.129-135
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• 2001

Purpose: To evaluate the radiographic results of the treatment for Danis-Weber type B lateral malleolar fracture with 2 cannulated screws. Materials and Methods: Thirty-four cases of Danis-Weber type B lateral malleolar fracture were available. Follow-up averaged 8 months (6-25 months). The medial clear space for lateral displacement of talus, talo-crural angle for lateral malleolar shortening, and malunion evidence of lateral malleolar fracture were observed. Results: Medial clear space was from 2mm to 4mm in 34 cases. Talo-crural angle was from $73^{\circ}$ to $82.5^{\circ}$ in 33 cases. One case was complicated with malunion of lateral malleolus. But, we found the same condition in the immediate post- operative radiographic film. Conclusion: We believe that the 2 cannulated screws fixation for Danis-Weber type B lateral malleolar simple fractures is an excellent treatment method.

• 대한족부족관절학회지
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• 제26권1호
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• pp.16-21
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• 2022

도수 또는 중력 외회전 부하 방사선 검사는 족관절 양과 유사 골절과 단독 외과 골절을 구별할 수 있는 기준이 된다. 부하 방사선 검사상 내측 관절 간격이 넓어지면 삼각인대 손상을 진단할 수 있고 비골 골절에 대한 수술적 처치가 권장된다. 비골 골절에 대하여 관혈적 정복술 후 Cotton test를 시행하여 경비원위인대가 벌어질 경우 이에 대한 고정을 시행한 후 삼각인대의 봉합술 시행 여부는 술자의 선호도 및 수술장 내 소견에 의하여 결정된다. 삼각인대 봉합술은 내과에 suture anchor를 삽입하고 심부와 천부 삼각인대에 대하여 중첩술 후 내과에 anchor를 통하여 고정함으로써 시행한다. 유일하게 무작위로 시행된 족관절 골절에서의 삼각인대 봉합술의 유용성 평가 연구에서는 삼각인대 봉합술의 유용성에 대하여 긍정적인 결론을 도출하지 못하였으나 연구 자체의 제한점이 많아 해석을 하는 데 있어 한계가 있었다. 추후 이에 대한 심도 있는 연구가 필요하리라 판단된다.

• 대한족부족관절학회지
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• 제8권1호
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• pp.86-91
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• 2004

Purpose: To evaluate the methods and results of the surgical treatment in the trimalleolar fracture of the ankle. Materials and Methods: We analysed the results of the ankle trimalleolar fracture which were treated with open reduction and internal fixation from January 1999 till September 2003. There were 45 patients who had at least six months follow up, 16 men, and 29 women. We have analysed the mechanism of injury, methods of operation and postoperative complications. Results: The results were assessed on ankle AP, lateral and mortise X-rays and retrospective chart review. There were 30 supination-external rotation, 13 pronation-external rotation, 2 pronation-abduction in the mechanism of injury by Lauge-Hansen classification. Cases of the posterior malleolar fracture which involved more than 25% of the weight bearing surface were 7 (15.6%). Medial malleolar mono-fixation was done in 5 cases, fibular mono-fixation in 2 cases, bimalleolar fixation in 32 cases, trimalleolar fixation in 6 cases. 38 cases (84.4%) were good or excellent in clincal assessment and 39 cases (86.7%) were good or excellent in radiological assessment according to the criteria of the Meyer. There was no difference of results among the surgical treatment methods. Conclusion: The results of our study indicate that the rigid fixation with early ankle motion and weight bearing is needed in ankle trimalleolar fracture. But minimal fixation is not bad in slight displaced fracture. Both anterior approach and posterior approach were useful methods to stabilization the posterior malleolar fracture. And pre-operative evaluation to detect the hidden soft tissue injuries and fracture mechanism is very important to avoid the failure.

• Journal of Yeungnam Medical Science
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• 제34권1호
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• pp.146-148
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• 2017

Concurrent injury of medial malleolus and deltoid ligament is difficult to occur considering the injury mechanism. When the concurrent injury comes about, the deltoid ligament injury could be missed and it may lead to medial ankle instability. There are few reported cases of the concurrent injury and domestic case of concurrent failure of both structures over the medial side has been reported just once; however, the injury mechanism is different from this case. The authors report a case of medial malleolus fracture with deltoid ligament rupture following pronation injury with a review of necessity of repairing deltoid ligament for ankle stability.

• 대한족부족관절학회지
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• 제18권1호
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• pp.29-35
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• 2014

Purpose: The purpose of this study is to compare the radiologic and clinical results of syndesmotic screw fixation and posterior malleolar fixation for syndesmotic injury in Lauge-Hansen classification pronation-external rotation (PER) stage IV ankle fractures with posterior malleolus fracture. Materials and Methods: We designed a retrospective study that included patients with Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture. Of 723 patients who underwent ankle fracture surgery from March 2005 to November 2012, 29 were included in this study. In this study, syndesmotic injury was treated with syndesmotic screw fixation or posterior malleolus fixation. There were 15 cases of syndesmotic screw fixation and 14 cases of posterior malleolar fixation. We compared the radiologic and clinical results at one year postoperatively. Posterior malleolus fragment size on a pre-operative computed tomographic image, and tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, and Takakura classification on a postoperative one year followup radiograph were used for comparison of the radiologic results. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society score, visual analogue scale score, and patient subjective satisfaction score. Results: Posterior malleolar fragment size was $12.62%{\pm}3.01%$ of the joint space in the syndesmotic screw fixation group and $27.04%{\pm}4.34%$ in the posterior malleolar fixation group. A statistical difference was observed between the two groups. However, other results, including tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, Takakura classification, and clinical scores showed no statistical difference. Conclusion: In the Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture, if the posterior malleolus fracture can be reduced anatomically and fixated rigidly, syndesmotic screw fixation, which can cause several complications, is usually not required for achievement of a satisfactory syndesmotic stability; this would be a recommendable option for treatment of syndesmotic injury.

• 대한족부족관절학회지
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• 제9권1호
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• pp.99-104
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• 2005

Purpose: The purpose of this study was to investigate usefulness of locking compression plate (LCP) as an open reduction technique by evaluating clinical results obtained from the patients with lateral malleolar fracture treated by internal fixation using LCP after open reduction. Materials and Methods: Among the patients with lateral malleolar fracture, the 28 patients who were treated by internal fixation using Locking compression plate after an open reduction and were able to be followed up for more than 6 months were included in this study. Final postoperative evaluation was done based on the Meyer's clinical and radiologic evaluation system. Results: All cases achieved anatomical reduction and fixation of the reduction postoperatively. 28 minutes were taken meaningly from the incision to the fixation of LCP plate after the anatomical reduction. Everage bony union time was 8.2 weaks, and the result was excellent in 23 cases (82%), good in 5 cases (17%) and poor result was abscent according to the criteria of Meyer et al. One case of post traumatic arthritis and one case of superficial infection on the operation site were found, but non-union, delayed union and malunion were not occurred. Conclusion: The internal fixation after open reduction using LCP is an effective treatment method in treating lateral malleolar fracture of the ankle since it offers advantages including easy application and a greater stability due to its capability of maintaining exact anatomical reduction even though the screw does not penetrate the medial cortex of fibular to add the stability and rigidity of the fixation.