Stability of Ankle Fracture–dislocations following Successful Closed Reduction

Abstract

ABSTRACT Introduction Following successful closed reduction, the ideal timing of operative fixation for ankle fracture–dislocations is not well understood. We sought to describe the rate at which initial reduction is lost between the Emergency Department (ED) and clinic visits, and to identify factors associated with loss of reduction. Materials and methods We identified 30 patients with isolated, closed ankle fracture–dislocations that were successfully reduced and splinted in the ED prior to operative intervention. The maintenance of reduction at follow-up clinic visit was defined as a success, and loss of reduction was defined as a failure. Results There were 17 (57%) successes and 13 (43%) failures. When the ratio of posterior malleolus (PM) fracture fragment size to complete articular surface was >0.1, rate of failure was 65% compared with 18% when the ratio was ≤0.1 (p = 0.016). Conclusion Ankle fracture–dislocations with a larger PM fracture fragment size may warrant consideration of earlier operative intervention. Level of evidence IV, Case Series. Matson AP, Green CL, Hurwitz SR, Zura RD. Stability of Ankle Fracture–dislocations following Successful Closed Reduction. The Duke Orthop J 2017;7(1):58-63.