الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The incidence of ankle fractures is increasing in the elderly population, particularly in females. Ankle fracture is one of the most common injuries that require surgical intervention.
Malleolar fractures and fracture-dislocations at the ankle result in more than 70% from a twisting force of the foot against the tibia like in a mis-step or fall. About 30% of malleolar fractures result from high-energy trauma e.g. road traffic accidents.
Isolated unimaleolar fractures are the most common type accounting for 70% of the yearly incidence of all ankle fractures. About 20 % of ankle fractures are bimalleolar fractures, while trimalleolar fractures represent about 7% of all ankle fractures. Open ankle fractures incidence is about 2% of all ankle fractures.
It is hard to distinguish an ankle fracture from a ligamentous injury reliably on the basis of the initial physical examination alone. Clues to a probable ankle fracture include swelling, hematoma formation, and tenderness to pressure over the medial and/or lateral malleolus or over the proximal head of the fibula.
The basic radiographic examination of the injured ankle includes true anteroposterior, mortise (AP with 15° internal rotation), and lateral views. There is consensus that the true size and geometry of the fragment, specifically its medial propagation, and intercalary fragments may be diagnosed only by CT scanning.
Stable fractures can be safely treated nonoperatively. Unstable fracture patterns require operative management (ORIF). The skin and soft tissues should be inspected, as excessive swelling and blisters may dictate that surgical treatment should be delayed.
A cross-sectional study conducted a study on patients with ankle fractures managed in the study hospitals and are eligible for percutaneous fixation. The study was carried out on 39 patients attending to Orthopedic Surgery Department, Faculty of Medicine, and Beni-Suef University after approved by local committee and an informed consent.
The study includes 39 patients, 16 patients (41%) were female and 23 patients (59%) were males, 59% of patients their fixation were in right side. Mean of age were 38.6 with range from 15 to 68 years. 14 patients (35%) were having diabetes mellitus. 11 patients (28.2%) were good Skin condition and 28 patients (71.8%) were bad Skin condition.21 patients (53.8%) their type of fracture was unimaleolar and 18 patients (46.2%) their type of fracture were bimaleolar. Fourteen patient (35%) were having associated Fractures.
In the study 15 patients (38.5%) were having Mild – occasional pain, 34 patients (87.2%) were having good Alignment, 14 patients (35.9%) were having Limited – restricted activity function and 3 patients (7.7%) were having infection. 32 patients (82.1%) were full union and 6 patients (15.4%) were delayed union. The Mean of Total AOFAS score were 92.44 with range from 58 to 100.
Percutaneous cannulated screws and K wiring technique is a simple and effective method that can be applied safely in patients with ankle fractures. It is a cheap and effective solution with a low complication rate.