Internal Fixation Of Ankle Fractures Research Articles

Cost of Surgical Treatment of Closed Ankle Fractures

Background: Assessment of costs following open reduction and internal fixation of closed ankle fractures has not been reported previously. Patients and Methods: All 224 patients admitted to Ulleval University Hospital with an ankle fracture during two 12-month periods in 1995 and 1998 were evaluated for inclusion, 191 patients (118 women, 73 men) treated by open reduction and internal fixation were followed up for a minimum of 3 months. Patients with multiple injuries (n = 10), open fractures (n = 10) and a clinical observation time < 3 months (n = 13) were excluded. The costs of surgery, hospitalization, follow-up appointments, and sickness benefits during the 1st postoperative year were assessed. Results: The overall cost of treatment in the 1st postoperative year was calculated at Euro 12,498.- (SD 8,728.-). The expenses did not significantly differ when comparing age, sex and fracture types. The difference in the total cost for the patients with no, minor and major soft tissue problems was highly significant (p < 0.001). Conclusions: The results of this study indicate that open reduction and internal fixation of ankle fractures are costly. Efforts should be made to avoid major complications as these increase the costs considerably.

Internal fixation of ankle fractures in the very elderly

The management of ankle fracture in the elderly remains controversial. A review of the early results of open reduction and internal fixation (ORIF) in 74 patients over the age of 70 years (average 76 years) was undertaken to identify the early complications, length of stay, return to pre-injury mobility and residential status. This revealed 1% deep infection, 9% delayed wound healing, 5% malunion, and 3% mortality. In 12% of patients, soft bone and comminution precluded fixation of one malleolus. The average length of stay for patients who walked with Zimmer frame (116±65 days) before injury was significantly longer than those who walked independently or with sticks (19±15 days; P<0.01). The inability of the patients to weight-bear early led to lengthy hospital stays and difficult socio-economic problems. However, the majority (85%) of patients regained their pre-injury mobility and residential status. We conclude that ORIF of ankle fractures in the elderly carries a significant risk of wound edge necrosis with delayed wound healing but the incidence of deep infection is relatively low. Poor bone quality presents technical difficulties but the majority of patients can expect good outcome.

Effects of Continuous Passive Movement and Plaster of Paris after Internal Fixation of Ankle Fractures

Summary In order to compare the effects of continuous passive movement and plaster of Paris on the outcome of patients under 50 years old after internal fixation of ankle fractures, two groups were selected at random and reviewed clinically after six and 12 months. The data collected indicated a significant improvement in the range of ankle motion, reduction in pain, and a reduction in the time taken between injury and return to full pre-fracture activity when continuous passive movement was used. All these improvements were achieved with no significant increase in post-operative complications or the length of hospital stay. It is suggested mat continuous passive movement provides a better outcome after internal fixation of ankle fractures than plaster of Paris in the group of patients studied.

Fixation of Ankle Fractures

A new method of internal fixation of ankle fractures with power-driven staples is presented. The results in 25 ankle fractures treated with this method were compared with those of 25 matched ankle fractures treated with Wiberg staples, cerclage, and Palmer pins. Reduction was exact in 22 fractures in the stapled group and in 23 in the routine group; all the fractures healed within 6 weeks. The only difference between the two groups was a gain of 20 min in operating time when using the power-driven staples (p less than 0.01). At follow-up observation 3 years later, no additional significant subjective, objective, or radiological differences appeared.

The Effect of Interferential Therapy on Swelling Following open Reduction and Internal Fixation of Ankle Fractures

This paper describes the methodology and results of a double-blind clinical trial to assess the efficacy of interferential therapy in the treatment of ankle swelling following open reduction and internal fixation of malleolar fractures. A total of 24 patients were allocated into control (placebo) and treatment groups. The interferential therapy group received a current at an intensity of 20 mA and a frequency of 0–100 Hz. Each patient received a daily session of treatment lasting 20 minutes until the fractured ankle was immobilised in a below-knee plaster cast (2–4 days post-injury). No difference in rate of swelling reduction or total swelling reduction was observed after 2–4 days of treatment. The results of the present study show that interferential therapy as described above does not reduce swelling following open reduction and internal fixation of ankle fractures.