Abstract
PurposeSurgical management of ankle fractures has been extensively studied in literature but studies investigating validated clinical results are lacking and controversial. The purpose of this study was to evaluate functional and health-related quality of life (HRQL) outcomes after surgically treated ankle fractures and to detect some of their predictors.MethodsTwo hundred sixty-six skeletally mature patients who underwent surgery for an isolated ankle fracture from 2006 to 2017 were retrospectively identified from our hospital records and included in the study. All patients were evaluated at one, three, six and 12 months post-injury with clinical and radiographic examination. Outcome measures recorded at final two years minimum follow-up included patient-reported pain, patient satisfaction, functional (American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score) and quality of life (Short Form (SF) 36 score) status.ResultsPatient satisfaction score was 8.4 out of 10, Visual Analogue Scale mean score was 2.3, complication rate was 36.5% and mean AOFAS ankle-hindfoot score was 87.3. Mean SF36-physical summary score was 77.9 and SF36-mental summary score was 81.1. The injury demonstrated a significant effect on physical function, role-physical, bodily pain and social functioning SF-36 subdomains. Functional outcome was significantly related to occupation, syndesmotic lesion, number of fractured malleoli and delay to surgery. Main predictors of quality of life were age, occupation, cause of injury, syndesmotic lesion, number of fractured malleoli and waiting time to surgery.ConclusionsAnkle fractures have a considerable impact on functional and quality of life status of patients. Occupation, presence of syndesmotic injury, Pott's classification and surgery delay must be considered as predictors of final outcome.
Highlights
Ankle fractures are the most frequent fractures seen at the major trauma centers, as far as foot and ankle injuries are concerned
The injury demonstrated a significant effect on physical function, role-physical, bodily pain and social functioning SF-36 subdomains
Functional outcome was significantly related to occupation, syndesmotic lesion, number of fractured malleoli and delay to surgery
Summary
Ankle fractures are the most frequent fractures seen at the major trauma centers, as far as foot and ankle injuries are concerned. They account for 10% of all fractures (second in frequency behind proximal femoral fractures) and are estimated to have an incidence of about 184/100,000/year in the USA [1]. It is anticipated that the number of these lesions could be expected to triple by 2023 [2] These fractures have traditionally been considered to have a good prognosis, more recent studies suggest that between 17% and 24% of patients may not have a satisfactory outcome [3]. In many cases their interpretation is limited due to methodological problems, such as poor sample selection, high loss of followup, inability to describe the predictive value of individual variables or combinations of variables or the use of
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