Il trattamento incruento delle fratture malleolari. Non-surgical treatment of malleolar fractures. A long-term retrospective study

The paper reports the non-surgical treatment of even the most severe and complex malleolar fractures in adults. A total of 202 patients (aged 17-70) were treated at the Orthopaedic Clinic of Genoa between 1979 and 1989 using a non-surgical method. The paper reports the immediate clinical and radiographical results obtained in these patients. In addition, 94 patients were followed up for varying periods after fracture with a mean follow up of 5.2 years; long term clinical results were positive in 76.5% of cases: pain, which was mostly slight, and stiffness, especially in the dorsal flexion of the foot, were the most frequent symptoms observed; their intensity was only disabilitating in a very small number of cases. Radiographic results showed a 35% incidence of post-traumatic arthrosis. This was most often seen in the more elderly patients and in those taking part in a longer follow-up, and, in particular complicated the most severe fractures and those with residual reduction defects, especially involving the peroneal malleolus.