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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
  • 8,450 View
  • 57 Download
  • 1 Citations
AbstractAbstract PDF
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.
Summary

Citations

Citations to this article as recorded by  
  • 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
Comparison of mortality between open and closed pelvic bone fractures in Korea using 1:2 propensity score matching: a single-center retrospective study
Jaeri Yoo, Donghwan Choi, Byung Hee Kang
J Trauma Inj. 2024;37(1):6-12.   Published online January 3, 2024
DOI: https://doi.org/10.20408/jti.2023.0063
  • 11,193 View
  • 141 Download
  • 2 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
Open pelvic bone fractures are relatively rare and are considered more severe than closed fractures. This study aimed to compare the clinical outcomes of open and closed severe pelvic bone fractures.
Methods
Patients with severe pelvic bone fractures (pelvic Abbreviated Injury Scale score, ≥4) admitted at a single level I trauma center between 2016 and 2020 were retrospectively analyzed. Patients aged <16 years and those with incomplete medical records were excluded from the study. The patients were divided into open and closed fracture groups, and their demographics, treatment, and clinical outcomes were compared before and after 1:2 propensity score matching.
Results
Of the 321 patients, 24 were in the open fracture group and 297 were in the closed fracture group. The open fracture group had more infections (37.5% vs. 5.7%, P<0.001) and longer stays in the intensive care unit (median 11 days, interquartile range [IQR] 6–30 days vs. median 5 days, IQR 2–13 days; P=0.005), but mortality did not show a statistically significant difference (20.8% vs. 15.5%, P=0.559) before matching. After 1:2 propensity score matching, the infection rate was significantly higher in the open fracture group (37.5% vs. 6.3%, P=0.002), whereas the length of intensive care unit stay (median 11 days, IQR 6–30 days vs. median 8 days, IQR 4–19 days; P=0.312) and mortality (20.8% vs. 27.1%, P=0.564) were not significantly different.
Conclusions
The open pelvic fracture group had more infections than the closed pelvic fracture group, but mortality was not significantly different. Aggressive treatment of pelvic bone fractures is important regardless of the fracture type, and efforts to reduce infection are important in open pelvic bone fractures.
Summary

Citations

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  • Surgical management and long-term functional outcomes of traumatic pubic symphysis diastasis: a retrospective cohort study
    Rajendra Aryal, Rajan Bhusal, Nitesh Raj Pandey, Ashok Kumar Banskota, Bibek Banskota
    BMC Musculoskeletal Disorders.2026;[Epub]     CrossRef
  • Open Pelvic Ring Injury with Extended Morel-Lavallée Lesion Complicated by Fungal Infection Necessitating Hemipelvectomy
    Vera Jaecker, Sven Märdian, Julius Krüger, Wenzel Schöning, Philipp Pickerodt, Martina Gaßner, Ulrich Stöckle, Marcel Niemann, Tazio Maleitzke
    JBJS Case Connector.2026;[Epub]     CrossRef
  • Severe soft tissue injuries in multiple trauma patients—a challenge we can meet? A matched-pair analysis from the TraumaRegister DGU®
    Nora Kirsten, Georg Maximilian Franke, Rolf Lefering, Tim Klüter, Matthias Weuster, Michael Müller, Sebastian Lippross, Andreas Seekamp, Stefanie Fitschen-Oestern
    Frontiers in Medicine.2025;[Epub]     CrossRef
Surgical Outcomes in Patients with Simultaneous Traumatic Brain and Torso Injuries in a Single Regional Trauma Center over a 5-Year Period
Jung-Ho Yun
J Trauma Inj. 2021;34(4):270-278.   Published online December 31, 2021
DOI: https://doi.org/10.20408/jti.2021.0099
  • 7,865 View
  • 134 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

The purpose of the study is to analyze the results of surgical treatment of patients with brain and torso injury for 5 years in a single regional trauma center.

Methods

We analyzed multiple trauma patients who underwent brain surgery and torso surgery for chest or abdominal injury simultaneously or sequentially among all 14,175 trauma patients who visited Dankook University Hospital Regional Trauma Center from January 2015 to December 2019.

Results

A total of 25 patients underwent brain surgery and chest or abdominal surgery, with an average age of 55.4 years, 17 men and eight women. As a result of surgical treatment, there were 14 patients who underwent the surgery on the same day (resuscitative surgery), of which five patients underwent surgery simultaneously, four patients underwent brain surgery first, and one patient underwent chest surgery first, four patients underwent abdominal surgery first. Among the 25 treated patients, the 10 patients died, which the cause of death was five severe brain injuries and four hemorrhagic shocks.

Conclusions

In multiple damaged patients require both torso surgery and head surgery, poor prognosis was associated with low initial Glasgow Coma Scale and high Injury Severity Score. On the other hand, patients had good prognosis when blood pressure was maintained and operation for traumatic brain injury was performed first. At the same time, patients who had operation on head and torso simultaneously had extremely low survival rates. This may be associated with secondary brain injury due to low perfusion pressure or continuous hypotension and the traumatic coagulopathy caused by massive bleeding.

Summary

Citations

Citations to this article as recorded by  
  • Chinese Guideline for the Diagnosis and Treatment of Head, Thoracic, Abdominal, and Pelvic Polytrauma (2026 Edition)
    Jian-Ning Zhang, Wang Jia, Yan-Bing Yu, Jia-Yu Liu, Zhi-Qiang Xue, Zhi Qiao, Xiang-Dang Liang, Xin Lou, Wei-Dong Mi, Tan-Shi Li, Fei-Hu Zhou, Gang Cheng, Jun-Zhao Sun, Wen-Ying Lv, De-Zhi Kang, Ning Wang, Rong-Cai Jiang, Jun-Ji Wei, Guo-Yi Gao, Zhou Fei,
    Neurosurgical Subspecialties.2026;[Epub]     CrossRef

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