Prediction of Functional Outcome of Surgical Treatment in Danis-Weber Type-C Closed Ankle Fracture Using AOFAS Ankle Hind Foot Score in a Tertiary Care Hospital

Abstract

Background: Fracture of the ankle is the most common fracture involving joints. Being a weight-bearing joint maximum thrust passes through it. It is a complex weight-bearing joint and is subjected to many different types of injury. Successful treatment will allow early mobilization to avoid complications. AOFAS Ankle Hind foot score is the most commonly used tool to measure this outcome. Objective: To assess prediction of functional outcome of surgical treatment in Danis-Weber type-C closed ankle fracture using AOFAS Ankle Hind Foot Score. Methods: A prospective observational study was carried out in Monno Medical College and Hospital, Manikganj, from June 2022 to December 2022. A total of 32 patients with Danis-Weber type-C ankle fracture were taken in this study. All the patients were initially managed by analgesic and short leg posterior slab. After admission, all were treated by ORIF with small DCP for fractured fibula and ORIF by two 4mm cannulated cancellous screws for fractured medial malleolus. Operations were done within 4 days to 14 days. The average follow up was 24 weeks. The outcome was assessed by the AOFAS score. Results: The mean age was 34.68+10.79 years with a male predominance, 23 (71%). Most of the patients, 14 (44%), were service holder. Right-sided injury, 20 (63%), were more than left. The main cause of injury was RTA, 22 (69 %), and the commonest mechanism of injury was pronation external rotation, 37 (84%). Syndesmotic injury was present in 28 (88%) cases. The mean duration of hospital stay was 14+2.68 days. Superficial infection was in 2 (6%) patients. The mean AOFAS pain score at 12th and 24th weeks follow up were 29.21+6.18 and 34.3+45.64, which was significant (p-.0005). The mean duration of radiological healing was 13.34+1.56 weeks. The mean dorsiflexion and plantar flexion at 12th weeks follow up was respectively 8.81±1.59 and 43.18+4.70; and 24th weeks follow up was respectively 10.87±1.43 and 51.25+1.11, which was significant .......