Journal of Trauma and Injury

Original Article

Clinical and radiological outcomes of bimalleolar ankle fractures treated with open reduction and internal fixation: a prospective observational study: Kumar VSV, Velmurugan Srinivasan, Rajasekar S, Muthu Adaikkappan, Hemapriya A S; J Trauma Inj. 2026;39(1):60-67. Published online March 30, 2026; DOI: https://doi.org/10.20408/jti.2025.0180

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Purpose
Bimalleolar ankle fractures are common injuries that typically result from trauma such as falls or road traffic accidents. Open reduction and internal fixation (ORIF) is the standard treatment and aims to restore proper alignment, stability, and ankle function. Despite the overall effectiveness of ORIF, patient outcomes may vary depending on age, sex, fracture type, and the timing of surgery. This study evaluates the clinical, radiological, and functional outcomes of bimalleolar ankle fractures treated with ORIF and identifies factors influencing recovery and complications.
Methods
A prospective observational study was conducted from January 2024 to January 2025. Forty patients over 18 years of age with bimalleolar ankle fractures who were medically fit for surgery were included. Patients with previous ankle fractures, significant comorbidities, or contraindications to surgery were excluded. All participants underwent ORIF and were assessed at 6, 12, and 24 weeks postoperatively for clinical, radiological, and functional outcomes. Functional results were evaluated using the Baird-Jackson scoring system.
Results
The mean age of patients was 44.1 years and 18 (45.0%) were male. The right ankle was affected in 25 cases (62.5%). Most injuries resulted from slips and falls (57.5%), followed by road traffic accidents (42.5%). Supination-external rotation fractures (55.0%) were the most common pattern. The average time to radiological union was 14 weeks. At final follow-up, 28 patients demonstrated excellent functional outcomes, 10 had good outcomes, and 2 had fair results. The complication rate was low, with superficial wound infection and implant prominence each occurring in two patients (5.0%).
Conclusions
ORIF provides favorable clinical and functional outcomes for bimalleolar ankle fractures, with most patients achieving good or excellent recovery. Timely surgery and stable fixation are essential to reducing complications. Sex had a slight influence on union time, whereas age, fracture type, and the affected side did not significantly impact outcomes.

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Citations

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Associations of Preoperative and Early Postoperative Biomarkers with Wound Complications in a Clinically Restricted Surgical Population: A Retrospective Cohort Study
Emre Erdoğan, Elif Nur Gencer, Teoman Bekir Yeni, Furkan Türkoğlu, Özgür Doğan
Journal of Clinical Medicine.2026; 15(19): 7647. CrossRef

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