The Volkmann dogma: a retrospective, long-term, single-center study

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
D HeimN Simbrey

Abstract

There has been (and still is) some controversy about the treatment of malleolar fractures with an additional fracture of the posterior malleolus (Volkmann triangle) in the last few years. Should a posterior malleolus with a fragment that is larger than 25% of the articular surface be fixed? Can long-term results be influenced by the fixation of the Volkmann triangle? In a consecutive series of 43/56 patients with a dislocated malleolar fracture, clinical and radiological results were analyzed after a follow-up of 7.3 years (4-11 years). There were 15 men with an average age of 53 years and 28 women with an average age of 62 years, respectively. Eleven fragments were fixed. At inspection, 16 patients displayed a cartilage lesion at the talar dome. No or only slight arthrosis was found on X-rays of 37/43 patients. Six patients showed moderate or severe arthrosis. The Olerud-Molander score was 95.5 in patients without a Volkmann triangle, 98.5 in the presence of a small, unfixed fragment, and 90.6 with a large fixed fragment. Patients with no cartilage damage on perioperative inspection presented less severe arthrosis in the long-term results, while those with documented cartilage damage during the operation had more severe arthro...Continue Reading

References

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Citations

Jul 23, 2011·Der Unfallchirurg·S RammeltH Zwipp
Aug 9, 2015·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·J BartoníčekO Naňka
Feb 25, 2015·Archives of Orthopaedic and Trauma Surgery·Jan BartoníčekIvo Trešl
Jan 12, 2020·Der Unfallchirurg·Konrad KaminStefan Rammelt
Sep 23, 2020·JBJS Reviews·Stefan Rammelt, Jan Bartoníček
Nov 3, 2017·The Bone & Joint Journal·M C Solan, A Sakellariou
Mar 10, 2021·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·T MalutaB Magnan
Apr 10, 2021·Archives of Orthopaedic and Trauma Surgery·Annika Pauline Neumann, Stefan Rammelt
Oct 27, 2020·Journal of Orthopaedic Trauma·Stefan RammeltAnnika Pauline Neumann

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