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Original Articles
- 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
- 268 View
- 8 Download
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Abstract
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
- Changes in interpersonal violence and utilization of trauma recovery services at an urban trauma center in the United States during the COVID-19 pandemic: a retrospective, comparative study
- Kevin Y. Zhu, Kristie J. Sun, Mary A. Breslin, Mark Kalina Jr., Tyler Moon, Ryan Furdock, Heather A. Vallier
- J Trauma Inj. 2024;37(1):60-66. Published online February 26, 2024
- DOI: https://doi.org/10.20408/jti.2023.0064
- 4,943 View
- 66 Download
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Abstract
PDF
- Purpose
This study investigated changes in interpersonal violence and utilization of trauma recovery services during the COVID-19 pandemic. At an urban level I trauma center, trauma recovery services (TRS) provide education, counseling, peer support, and coordination of rehabilitation and recovery to address social and mental health needs. The COVID-19 pandemic prompted considerable changes in hospital services and increases in interpersonal victimization.
Methods
A retrospective analysis was conducted between September 6, 2018 and December 20, 2020 for 1,908 victim-of-crime patients, including 574 victims of interpersonal violence. Outcomes included length of stay associated with initial TRS presentation, number of subsequent emergency department visits, number of outpatient appointments, and utilization of specific specialties within the year following the initial traumatic event.
Results
Patients were primarily female (59.4%), single (80.1%), non-Hispanic (86.7%), and Black (59.2%). The mean age was 33.0 years, and 247 patients (49.2%) presented due to physical assault, 132 (26.3%) due to gunshot wounds, and 76 (15.1%) due to sexual assault. The perpetrators were primarily partners (27.9%) or strangers (23.3%). During the study period, 266 patients (mean, 14.9 patients per month) presented before the declaration of COVID-19 as a national emergency on March 13, 2020, while 236 patients (mean, 25.9 patients per month) presented afterward, representing a 74.6% increase in victim-of-crime patients treated. Interactions with TRS decreased during the COVID-19 period, with an average of 3.0 interactions per patient before COVID-19 versus 1.9 after emergency declaration (P<0.01). Similarly, reductions in length of stay were noted; the pre–COVID-19 average was 3.6 days, compared to 2.1 days post–COVID-19 (P=0.01).
Conclusions
While interpersonal violence increased, TRS interactions decreased during the COVID-19 pandemic, reflecting interruption of services, COVID-19 precautions, and postponement/cancellation of elective visits. Future direction of hospital policy to enable resource and service delivery to this population, despite internal and external challenges, appears warranted. -
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