Fifty-five patients with displaced bimalleolar ankle fractures were evaluated subjectively, objectively, and roentgenographically at an average of eight years after injury. Twenty-eight patients were treated by open reduction and internal fixation of both malleoli and twenty-seven by closed methods. Most of the excellent results were obtained by open treatment, but when excellent and good results were combined, the results following closed reduction were slightly better. Non-union and malunion were more frequent following closed treatment but did not affect the end result except when there was non-union of the medial malleolus at the level of the tibial plafond. Idiopathic joint degeneration occurred in eight patients who had anatomical reductions, seven by open methods. Objective clinical findings usually did not change after one year from the time of injury, and progression of arthrosis was not seen later than five years after injury.
Copyright 1966 by The Journal of Bone and Joint Surgery, Incorporated