Following are pre and post treatment xrays of a patient with bimalleolar fracture with ankle dislocation.
This is a case of 40 years old male patient who sustained injury after fall from moving bike. First is the xray done immediately after patient came to hospital.
This xray contains anteroposterior view on left side and lateral view on right side.
You can see fracture medial and lateral malleoli along with dislocation of the ankle.
What follows is the xray of the same patient after he has been operated
Both the fractures have been fixed. Lateral malleolus has been fixed with one third semitubular plate. For medial malleolus tension band wiring has been done.
Author’s Note
- Dislocation occurs with bimalleolar fractures when trauma is quite severe. Because two malleoli provide stability to the ankle joint, fracture of the both with ligamentous disruption causes dislocation of the ankle.
- Implant of choice for medial malleolus is malleolar screw but in this case the fragment of medial malleolus is too small for a screw. So kwire fixation and tension band wiring has been performed.
Hello,
This posts follows from one i made yestarday as i just noted the x-rays above of ‘Bimalleoalar Fracture and ankle dislocation’. This is almost the same as my post op x-ray, just instead of the two smaller screws to the medial malleolus i have one large one.
May i know your opinion on approximate recovery time and when i can begin to put wieght on this foot?
Thanks,
Whittle
i have a bimalleoli lt. with sever oedema and blister formation three years ago.
fixation done with TB wiring and 1 malleolar screw which is still there.
Can we continue with screw-wiring arrangement?
IF i want to remove it, how much time it will take to full recovery?
Thanks
Birendra
Dr Arun Pal Singh Reply:
September 20th, 2009 at 8:05 am
@Birendra,
That is one form of treatment for these fractures.
The hardware should not be removed if it does not cause a problem.
9-12 months waiting period is advised otherwise before removal.
I had a bimalleaolar fracture & dislocation in June 2008, it got fixed and i can jog quite well now, with only a slight stiffness when i sit for long. How long should i have the screws on for? If they are removed will it cause me to keep limping? What if i keep the screws on forever? does it matter?
Joyce.
Dr Arun Pal Singh Reply:
March 17th, 2010 at 8:47 pm
@Joyce,
If they do not trouble you, they can be kept forever. Otherwise they can be removed.
My wife has undergone left foot bimalleolar fracure. Now it has been 8 months since the surgery and still she is experiencing a lot of pain although the doctor keeps telling her that the bones have healed .What might the problem be ?
Dr Arun Pal Singh Reply:
June 14th, 2011 at 12:55 am
@Ismat Ibrahim Ismail,
Did you ask your doctor? What were you told? What is the knd of pain ongoing?
Yes , I asked the doctor but he told me that the x-rays howed that everything is ok and that the fracture has heald . AT first , he said it was neuroma. Later he said it was an inflamation of the tendon and prescribed some tabs for pain killing. the pain is mostly near the ankle on the lower left side of the left foot.
Dr Arun Pal Singh Reply:
June 24th, 2011 at 7:43 am
@Ismat Ibrahim Ismail,
Most plausible explanation would be injured soft tissue (?ligament?) which is still troubling. Should go away with time.
I would also like to rule out any missed injuries.
If you think things are not improving, getting another opinion might help.