Evaluation Of The Conservative Treatment In Supination-eversion â…£Ankle Fractures And Dislocation

Objective:To study the results of the conservative management of the supination-eversion Ⅳ (SERⅣ) fractures of ankle.Methods:40patients of SERIV ankle fractures were treated.There were19males and21females with an average age of54years (ranged from16to78years).They included15cases with injury on the left ankle and25on the right.All patients were treatd by manual closed reduction and inverted plaster external fixation for7-9weeks (the average was8weeks), then were changed neutral plaster external fixation for3weeks.Results:37/40were followed up for12.7months in average (ranged from10to15months).According to the Olerud and Molander ankle scores,the mean score was71(ranged from40to100).There were cxcellent results in17cases, good results in9cases, poor results in6cases, bad results in3cases and failed results in2cases who had been treated by surgery.To radiographic measurement, on average, the medial joint gap width was measured as (4.7±1.0) mm, the inferior tibiofibular gap width was (5.6±1.3) mm, the overlap width of inferior tibia and fibula was (3.0±2.8) mm, the supramalleolar tibiotalar gap width was(3.7±0.6)mm, and tibiotalar gap width on lateral radiogram was (3.7±0.7) mm.Conclusion:Most cases with SERIV ankle fractures can obtain normal function with exact closed reduction, stable plaster external fixation and active postoperative rehabilitation.But the long-term results need further boservation because of the talus exists a certain degree of lateral displacement in the radiographic measurement.