Comparison of Single-Window and Two-Window Posterolateral Approaches in Posterior and Lateral Malleolus Fractures: A Clinical Outcomes Analysis

What this Trial Is About

Researchers are evaluating the outcomes of two different surgical techniques for treating ankle fractures involving the posterior and lateral malleoli. This prospective clinical trial aims to determine if the single-window posterolateral approach reduces soft-tissue complications by minimizing surgical dissection, without affecting fracture stability. Patients with acute, closed ankle fractures requiring surgical fixation will be studied and followed for 12 months to assess wound healing, ankle function, pain, and implant irritation. Participants will be randomly assigned to one of two groups: one group will receive surgery using a single-window approach with a posterior antiglide plate to fix both malleoli through one surgical interval medial to the peroneal tendons. The other group will undergo the traditional two-window approach, involving two surgical intervals—one medial and one lateral to the peroneal tendons—with fixation of the fibula using a standard lateral anatomic plate. Both techniques aim to stabilize the fracture but differ in surgical exposure and plating methods. Throughout the study, patients will be closely monitored for early wound complications within the first three months after surgery. Further evaluations at 6 and 12 months will include functional assessments using the American Orthopaedic Foot and Ankle Society (AOFAS) score, ankle range of motion measurements, and pain levels using the Visual Analog Scale (VAS). The total participation duration is 12 months postoperatively, during which recovery and implant-related issues will be recorded to compare the effectiveness and safety of both surgical techniques.

Single-Window Versus Two-Window Posterolateral Approach for Malleolar Fractures