الفهرس 
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Abstract
The mean age of the patients in this study was 41.045 ± 12.963 years. There were two females (10%) and eighteen males (90%). The right side was affected in eleven (50%) ankles while eleven (50%) had left sided fractures. Falling from height was the mechanism of trauma in fourteen (63.6%) ankles and road traffic accident in eight (36.4%).
Fractures were classified according to AO classification of fractures of long bones was type”43 B‖ in two (9.1%) ankles, both were subtype B2 whereas type ―43 C‖ occurred in twenty ankles (90.9%) , seven (32%).of them were type 43 C1, three (13.6%) were type 43 C2 and ten (45.5%) were type 43 C3.
Four patients (20%) had lower limb fractures (one patient with femoral fracture, one patient with metatarsal fracture and two patients with calcaneal fracture), one patient (5%) had vertebral fracture, three patients (15%) had concomitant upper and lower limb fractures (one patient with humeral and tibial fracture, one patient with scaphoid and femoral fracture and one patient with tibial and radial fracture)) while 13 (65%) had no associated fracture.
The mean time lapse between trauma and surgery was 6.18 days;( range 1-17 days). The mean duration of follow up 10.82 ± 5.448 months (range 6 – 23 months). The mean duration of cast was 3.75 ± 1.021 months.
Minimally invasive percutaneous osteosynthesis of closed tibial plafond fractures was performed; the fibula was fixed by the appropriate method of fixation. A vertical incision centralized over the tip of the medial malleolas about 3 cm in length was done. Reduction of tibial articular surface fragments either by in direct percutaneous method or limited open technique and fixed momentarily by Kirschner wires, K-wires were then replaced by interfragmentary small set screws and the distal tibial locked plate was inserted through the incision and slided subcutaneously till the tibial shaft. Indirect reduction of the metaphyseal fracture was done with pointed reduction clamp percutaneously and then the distal locked head screws were inserted in the distal fragments in the reduced position. Stab incisions over the proximal locked screw holes were done and then locked head screws were placed.
A below knee slab was applied and elevation of the leg two days post operative.
After the follow up period the results were assessed clinically, the patients were observed and the functional results were assessed according to Mazur et al scoring system. four (18.2%) ankles were classified as excellent, nine (40.9%) were classified as good, four (18.2%) were classified as fair and five (22.7%) were classified as poor at the end of follow up. For statistical purpose, excellent and good results were grouped as ”Satisfactory” which was found in 59.1% while fair and poor results were grouped as ”Unsatisfactory” which was found in 40.9%.
The final results was statistically significant in relation to age, duration of cast, accuracy of reduction, return to pre-injury occupation, degree of edema and complications. The final result was not affected by gender, mode of trauma, type of fracture, time lapsed between trauma and surgery, soft tissue condition, degree of edema, technique of reduction, associated fractures, presence of fibular fracture and difference in range of motion between the two ankles.