Eperience of ankle arthroscopy in the treatment of Herscovici B.C type medial malleolus fracture

Abstract Background: Ankle fracture is one of the most common intra-articular fractures, which accounts for about 3.9% of adult systemic fractures. For displaced and unstable ankle fractures, the traditional treatment method is open reduction and internal fixation(ORIF).However,the incidence of postoperative complications ORIF is as high as 36%,So.the purpose of this study was to evaluate the safety and efficacy of ankle arthroscopy in the treatment of Herscovici B.C medial malleolus fractures.Methods: From July 2018 to October 2020, 21 patients with Herscovici B.C type medial malleolus fractures (16 males and 5 females, with an average age of 37.2 years, ranging from 28 to 56 years) underwent closed reduction and internal fixation under ankle arthroscopy. During the follow-up period, the American Orthopaedic Foot and Ankle Society (AOFAS) were used to evaluate the curative effect.Results: All the 21 patients were followed up for 8 ~ 15months, with an average of 12.5 months. the average VAS scores on the 3rd and 2nd week after surgery were 2.6 (range, 2-3) and 1.5 (range, 1-2), the average AOFAS ankle scores at the 6 months and 1 year were 80.2 ( Range, 76-84) and 92.9 (range, 88-98). The wounds of all patients reached stage I healing, and no wound infection was reported. 1 case of superficial peroneal nerve injury was found. Medial malleolus fractures achieved bone union time was 8-12 weeks, with an average of 10.5 weeks. Conclusion: Closed reduction and internal fixation under ankle arthroscopy for the treatment of Herscovici B.C medial malleolus fractures, with less damage, reducing local blood supply damage to the fracture, and facilitating the healing of the fractured end, as well as the reduction of wound infection rate, and is conducive to the recovery and exercise of early ankle joint function.