Posterior ankle arthroscopic reduction and fixation for treatment of posterior malleolus fractures with absorbable screws.

PURPOSE: To explore the clinical efficacy of posterior ankle arthroscopy with absorbable screws in treating posterior malleolus fractures (PMFs).

METHODS

The data of 33 patients who underwent posterior ankle arthroscopy with absorbable screws for the treatment of PMFs between January 2022 and December 2023 were retrospectively analyzed. The surgical time, postoperative secondary injuries and soft tissue complications were recorded. The articular surface reduction quality and syndesmotic congruence were observed under X-ray and 3D CT. At the last follow-up, the ankle joint flexion mobility and occurrence of toe flexion contracture were recorded. Pains were assessed using Visual Analogue Scale (VAS). Functional efficacy was evaluated using American Orthopeadic Foot and Ankle Society (AOFAS) score, and Olerud-Molander Ankle Score (OMAS).

RESULTS

No secondary injuries or complications occurred postoperatively. The reduction of articular surface and the syndesmotic congruence were good. The fractures had no reduction loss and were all healed on time. At the last follow-up, the ankle joint flexion mobility was excellent, and there was no complication of toe flexion contracture. The VAS scores were 0.67 ± 0.92, the AOFAS scores were 92.73 ± 6.77, and the OMAS scores were 94.84 ± 7.01.

CONCLUSIONS

Posterior ankle arthroscopic reduction and fixation for treatment of PMFs with absorbable screws enables direct visualization of articular surface reduction and fixation, avoiding secondary removal of internal fixation and reinjury of soft tissues. Good ankle joint functions can be obtained through soft tissue protection and precise reduction, indicating this scheme is an optional surgical method.