The talus bears more weight per unit area than anyother bone ot the body, and, since thestress per unit area increases as the total contact area decreases, minimal displacement produces remarkable alterationin tibiotalar contact pressure
resulting
in
poor outcome after the ankle fracture. Therefore restoration of articcular surface and stable internal fixation must be achieved so that motion can be begun early.
The authors reviewed eight cases of the residual anterior subluxation after operation for the ankle fractures at the Department of Orthopaedic Surgery, Dong Kang Hospital from January, 1988 to June, 1991. In four cases, transfixing screws were
inserted
too tightly without dorsiflexion of the ankle during insertion. Postoperative X-ray films revealed incompoete reduction of the fibula mallous in three, cases, and incomplete reduction of the anterior lip of the distal tibia in
pronation-dorsiflexion
injury in one cases. Among them, seven cases showed spontaneous reduction during the period between six and twelve weeks after operation during which time the tlansfixing screw was removed and/or weight bearing was allowed. One case showed
persistent
subluxation of the ankle even at 12 months after operation. The overall result showed excellent in three, good in twom fair in two cases and poor in one case.
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