Early versus delayed surgery for ankle fractures: a comparison of results

Abstract

A retrospective review of closed ankle fractures treated using open reduction and internal fixation (ORIF) was undertaken. The aim was to investigate if the timing of surgery had any influence upon soft tissue complications and hospital stay. Sixty-two patients, 31 men and 31 women, were reviewed. Twenty-four (39%) underwent the surgery within 24 h (average 17.5 h) of injury, while the other 38 (61%) were operated at an average of 3.1 (2–9) days. The average length of stay (LOS) was 7.1 (range 2–15) days in patients who had the surgery within 24 h of injury as compared to 10.6 (range 4–64) days in those who had their surgery after 24 h of injury. The post-operative stay was 6.3 days as compared to 7.5 days in the two groups respectively. Fourteen complications were seen, including six infections all of which occurred in patients who underwent surgery after 24 h of injury. Three cases with delayed wound healing were also noted. A significantly higher complication rate was noted in patients aged 70 years or older (6/11). We conclude that delay in ORIF of ankle fractures is associated with increased complication, increased morbidity and increased hospital stay. These fractures should be surgically fixed within 24 h.