Ankle presentations in Awka, Nigeria; Treatment methods and outcome

Abstract

Introduction: The ankle joint, integral to dynamic movement, is prone to a variety of pathologies due to its complex structure and the substantial load it bears during activities such as sprinting, where it can carry up to thirteen times the body's weight. Stability is maintained through passive components like ligaments and bony contours, as well as dynamic forces, including muscle action. Injuries, which can be categorized by systems like the Danis-Weber AO and Lauge-Hansen classifications, are common in diverse settings and can lead to conditions like post-traumatic osteoarthritis. This study explores the prevalence, management, and outcomes of ankle injuries in an orthopaedic hospital setting, aiming to enhance understanding and treatment approaches for these conditions. Methodology: This prospective study analyzed all ankle cases at an orthopaedic hospital in Awka, Nigeria, from 2017 to 2023. Patients were evaluated and diagnosed via history, physical examinations, and investigations, including X-rays classified by the Danis-Weber system. Treatments ranged from surgery, including ORIF and arthrodesis, to casting for undisplaced fractures. Result: This study found the mean age of patients presenting with ankle injuries to be 41.44 years, affecting a wide demographic from 10 to 78 years. Males comprised 60.6% of the cases, and civil servants, who constituted 33.3%, were predominantly affected. The major causes were road traffic accidents (45.5%) and falls (33.3%). Ankle injuries, primarily right bimalleolar fractures, were common and involved significant trauma history. Treatments included ORIF, arthrodesis, and casting, with a high success rate of 97% inpatient recovery and satisfaction, indicating effective treatment protocols for various ankle pathologies, including closed and open injuries. Conclusion: The study illustrates that ankle injuries, predominantly resulting from road traffic accidents and falls, affect a diverse demographic across all ages and occupations, with a majority being male and often involving previous trauma, with closed injuries being the most common and effectively treated primarily through ORIF.