KẾT QUẢ PHẪU THUẬT ĐIỀU TRỊ GÃY BA MẮT CÁ CHÂN TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

Objective: To evaluate the outcomes of internal fixation surgery in the treatment of trimalleolar ankle fractures at Viet Duc University Hospital. Subjects and methods: A prospective longitudinal descriptive study was conducted on 31 patients with trimalleolar ankle fractures who underwent internal fixation at Viet Duc University Hospital between March 2024 and April 2025. Results: The mean age of patients was 36.7 ± 11.0 years. All patients presented with typical clinical symptoms, including pain, restricted ankle motion, swelling, perimalleolar ecchymosis, and localized tenderness. Radiographic assessment showed fractures classified predominantly as AO type B3 (48.4%) and C2 (51.6%); according to the Danis–Weber system, Weber B (51.6%) and Weber C (48.4%) were most frequent. Posterior malleolar fractures classified by Mason revealed type IIA as the most common (29%). Surgically, fixation of the medial malleolus was mainly achieved with cancellous screws (90.3%), whereas the lateral malleolus was stabilized with either distal fibular plates or reconstruction plates in nearly equal proportions. For posterior malleolar fractures, cancellous screws (45,4%) and T-plates (50%) were the most commonly employed. Postoperative radiographs demonstrated good outcomes in 93.5% of cases, and complete bone union was observed in 71% at 6 months. Long-term functional evaluation showed a mean score of 89.4 ± 6.4, with 51.6% rated as good–excellent, 38.7% as fair, and only 9.7% as poor. Conclusion: Internal fixation is an effective treatment for trimalleolar ankle fractures, achieving a high union rate, good functional recovery of the ankle joint, and a low complication rate.