O1124 METHYLPREDNISOLONE’S EFFECT ON POST-TRAUMATIC EDEMA IN MALLEOLAR FRACTURES

Introduction: Objective of our study is to present the effect of methylprednisolone sodium succinate (Solu-Medrol) on post-traumatic edema and on skin quality after a malleolar fracture. Material and Methods: 35 patients with an ankle fracture presented in our clinic from October 2001 till April 2002, 14 of whom had a surgical treatment by the day of their admission. The rest of them (a total of 21) were admitted in our clinic and were classified into 3 groups of 7 patients each. In two first groups was administered methylprednisolone in I.V. infusion during the first post-traumatic 8 hrs. Most specifically: In the first group was administered methylprednisolone I.V. in a dosage form of 500 mg every 12 hrs, for a day. In the second group was administered methylprednisolone I.V. in a dosage form of 250 mg every 8 hrs, also for a day, while in the third group there was no methylprednisolone administration. The perimeter of the ankle in lateral malleolus area was measured in both injured and healthy leg, the day of patient’s admission and the day after. The healthy leg was used as a control and skin condition was estimated clinically. Results: In group 3 there was a great increase in injured limb perimeter (of about 4–5 cm) the 2nd day and we found Chassaignac blisters of a good size (about 3–4 cm) in two patients. The first two groups presented a similar result, that means a moderate increase in injured limb perimeter without blister formation or skin necrosis. Discussion: In time intravenous administration of methylprednisolone minimized the post-traumatic edema in malleolar fractures and improved the quality of the skin which is usually an important problem in injuries of that type and prolong the hospitalization of these patients. Dosage of 250 mg x 3 for a day is equally effective compared to bigger doses and we suggest it because of the reduced danger for corticosteroids side effects.