Ankle fracture: The operative outcome of 30 patients

Abstract

Background & Objectives: Ankle fractures are the most common injuries treated by orthopaedic surgeons. However very few investigators have examined the functional recovery following operative treatment of ankle fractures. Anatomic restoration with open reduction and internal fixation is the goal of management in ankle fractures. The purpose of this study is to analyse the functional outcome following operative treatment of ankle fractures using subjective as well as objective criteria. Methods: 30 patients with ankle fractures who fulfilled the inclusion criteria were included in the study. All patients underwent surgical fixation of the fractures. The follow-up assessment which consisted of subjective (Pain, Walking, activity, Radiographs, Ankle and Subtalar Joint function) and objective (Ankle-Hindfoot Scoring System) evaluations, were performed at 6 weeks, 3 months and 9 months postoperatively. Results: Out of 30 patients, the commonest injury pattern seen was supination external rotation followed by pronation external rotation. The most common modality of fixation for the lateral malleolus was 1/3rd tubular plate and for the medial malleolus was 4 mm cannulated cancellous screws with washer, K-wire and tension band wiring and for the posterior malleolus fixation with lag screws and Syndesmotic screws for syndesmotic injuries. At 6 weeks follow-up of 60% (n=19) had complications of persistent swelling and residual pain, Which improved significantly in function from 3rd month to 9 month postoperatively. However subjective radiographic assessment shows statistically significant improvement. The mean Ankle-Hindfoot Scoring System was statistically significant 50.5±18.7 at 3rd month post-op and, 85.1±14.2 at 9th month post-op. Age was a significant predictor of final outcome, with younger patients having a better functional outcome. Conclusions: Anatomical reduction of ankle fracture results in good functional outcome postoperatively. Early treatment without delay, anatomic reduction and fracture fixation, stringent postoperative mobilization and rehabilitation should help improve outcome in an operated ankle fracture.