Arthroscopic Findings During Routine Ankle ORIF: What is Being Missed?

Abstract

The aim of study is to document our experience and intra-articular findings at time of routine ankle arthroscopy during ankle open reduction internal fixation (ORIF) and to contribute to the growing body of literature that shows this to be a safe and effective treatment. This is a retrospective review of ankle fractures who were treated with ORIF and arthroscopy by a single surgeon. The patients’ charts including operative reports, office notes, and images were reviewed to identify intra-articular pathology and fracture type. Analysis was performed with regard to fracture type, presence and location of osteochondral lesions, presence of loose-body, syndesmotic injury, and deltoid injury. Fifty-seven ankle fractures were identified and met inclusion criteria. 84.2% of the fractures had intra-articular pathology, most commonly a syndesmotic injury followed by loose joint body and osteochondral defect. Orthopedic surgeons with any arthroscopic prowess should consider arthroscopic evaluation during ankle fracture ORIF, particularly pronation external rotation and supination external rotation patterns. The benefits include a more detailed examination of associated injuries and possible treatment of pathology at the time of arthroscopy. This is a safe and effective compliment to routine ORIF for ankle fractures.