Minimally Invasive Internal Fixation for Gustilo Type Ⅲ Opening Ankle Fracture with Dislocation: A Case Report and Literature Review

Abstract

With the development of modern transportation industry, the incidence of opening ankle fracture with dislocation caused by high-energy injury is increasing year by year. There are many clinical reports of complications caused by improper treatment, such as skin necrosis, wound infection, traumatic arthritis, malunion, etc. Moreover, opening injury is often combined with other fractures and organ injuries, and the condition is generally more critical. Its treatment is also controversial, and the treatment program has become an urgent clinical problem to be solved. According to domestic and foreign literature reports, Gustilo type Ⅲ opening ankle fracture with dislocation is a composite injury of multiple ankle fractures and dislocations caused by high-energy impact. Most of these patients have severe soft tissue injury and are prone to necrosis and infection. Traditional treatment usually combines limited internal fixation and external fixation to assist fixation, which can ensure the treatment of opening soft tissue injury, reduce the incidence of infection, and directly observe the condition of the limb or wound, which is helpful for later treatment. However, there are still many side effects such as ankle stiffness and poor functional recovery after external fixation, so the treatment of opening ankle fracture with dislocation needs to be explored urgently by medical workers. In 2025, the author used minimally invasive internal fixation to treat a case of Gustilo type Ⅲ opening ankle fracture with dislocation, and achieved very satisfactory results.