Evaluation of the Result of Small Locking DCP Fixation in Danis-Weber Type-C Ankle Fracture

Abstract

Introduction: In traditional techniques, it is very difficult to align and stabilize the Danis-Weber type C ankle fracture. Small locking Dynamic Compression Plates (DCP) showed good result for other long bone fracture management. Here, we evaluated the functional outcome of fibula fixation in Weber type C fracture with small locking DCP. Methods and Materials: This was a quasi-experimental study carried out in National Institute of Traumatology & Orthopedic Rehabilitation (NITOR), Bangladesh from July 2014 to July 2016. Twenty patients with Danis-Weber type C ankle (closed) fracture purposively selected and treated with small locking DCP by extra periosteal bridging. The patients’ outcome evaluated functionally with the use of American Orthopedic Foot and Ankle Society Score (AOFAS). Results: The mean age of the patients was 36.75 (±8.93). Majority of the patients 15 (75%) were male, and the commonest 14 (70%) cause of fracture was RTA. The mean time interval between operation and injury was 12.25 (±5.12) days and mean duration of the operation was 77.37 (±22.36) minutes. Majority of the patients, 13 (65%) had no post-operative complications. All fractures healed without displacements. The mean AOFAS score was 83.25 (±7.30). Patients had mostly 18 (90%) satisfactory (AOFAS score ≥75) outcome following surgery. A time interval of ≤ 14 days between surgery and operation (p= 0.016), duration of operation ≤120 minutes (p= 0.005), and radiological healing time <16 weeks (p= 0.021) were significantly associated with satisfactory post-operative outcome.  Conclusions: Overall, post-operative outcome of plating by bridging technique with small locking DCP in Danis-Weber type C ankle fracture was satisfactory. This technique can be an effective method for treating such fractures. However, generalization must be with caution owing to the limitations of the sampling methods and small sample size.