Operative treatment of displaced lateral malleolar fractures: the Knowles pin technique.

OBJECTIVES

To assess the use of Knowles pin fixation for isolated displaced lateral malleolar fractures and to present our surgical experience using this method.

DESIGN

Retrospective evaluation.

SETTING

The study was carried out at a municipal teaching hospital. The senior surgeons were all orthopedic trauma subspecialists.

PATIENTS: A total of 168 patients meeting our inclusion criteria, an isolated displaced lateral malleolar fracture surgically treated by a Knowles pin between 1995 and 2000, were studied. All the patients had a stable syndesmosis, less than 50% comminution, and had no other operations in the same extremity. Patients were assigned into 4 groups according to the Orthopedic Trauma Association classification of ankle fractures.

INTERVENTION: Open reduction and internal fixation with a Knowles pin fixation of the lateral malleolus.

MAIN OUTCOME MEASUREMENTS: Functional results were evaluated using the Baird and Jackson ankle scoring system.

RESULTS

There was a 100% union rate. The average satisfactory outcome of the 4 groups was 88.1%. No instrumentation problems were encountered. Three complications occurred, but resolved with nonoperative therapy.

CONCLUSIONS

Knowles pin fixation for displaced lateral malleolar fractures is a useful and effective method. This implant offers several advantages, including easy application, less soft tissue dissection, less palpable instrumentation, stable fixation, and a short operating time.