Low Fracture Research Articles

A finite element model for investigating the influence of keel design and position on unicompartmental knee replacement cementless tibial component fixation

ObjectivesThe cementless Oxford Unicompartmental Knee Replacement (OUKR) tibial component relies on an interference fit to achieve initial fixation. The behaviour at the implant-bone interface is not fully understood and hence modelling of implants using Finite Element (FE) software is challenging. With a goal of exploring alternative implant designs with lower fracture risk and adequate fixation, this study aims to investigate whether optimisation of FE model parameters could accurately reproduce experimental results of a pull-out test which assesses fixation. Materials and methodsFinite element models of implants with three methods of fixation (standard keel, small keel, and peg) in a bone analogue foam block were created, in which implants were modelled using an analytical rigid definition and the foam block was modelled as a homogenous linear isotropic material. The total interference and elastic slip were varied in these models and optimised by comparing simulated and experimental results of pull-out tests for two (standard and peg) implant geometries. Then the optimised interference and elastic slip were validated by comparing simulated and experimental data of a third (small keel) implant geometry. ResultsThe optimisation of parameters established an interference of 0.16 mm and an elastic slip of 0.20 mm as most suitable for modelling the experimental force–displacement plots during pull-out. This combination of parameters accurately reproduced the experimental results of the small keel geometry. The maximum pull-out forces from the FE models were consistent with experimental data for each implant design. ConclusionsThis study shows that experimental pull-out tests can be accurately modelled using adjusted interference values and non-linear friction and outlines a method for determining these parameters. This study demonstrates that complex problems in modelling implant behaviour can be addressed with relatively simple models. This can potentially lead to the development of implants with reduced risk of failure.

Falls From Heights: A Retrospective Review of Roof Fall-Related Trauma.

Background Falls from roofs (FFRs), while constituting just a segment of all falls, pose a significant public health issue. They not only impact individuals in their daily lives but also pose an increased risk in the construction field. The consequences of these falls range broadly, from minor bruises to serious harm, potentially leading to chronic disability or fatality. For the general populace, such falls might happen during simple activities like maintenance, with outcomes varying from fractures to critical head or spinal injuries. In construction, where elevated work is the norm, the likelihood and potential severity of falls are significantly greater. Construction workers face the threat of falls regularly, with these mishaps often resulting in enduring disabilities that affect both life quality and work capability. Methodology This study presents data from a trauma registry system, covering trauma admissions from March 31, 2016, to December 27, 2021, at a level 1 trauma center (Desert Regional Medical Center, Palm Springs, CA). During this five-year and eight-month period, a total of 3,148 patients presented to the emergency department after a fall. This study focuses on patients admitted after an FFR. A retrospective analysis of this data showed that out of these 3,148 patients, 75 presented after an FFR. Results In this retrospective analysis of 75 patients presenting to the emergency department after an FFR, the patient profile was predominantly male (70, 93%), with an average age of 51 years. Hospitalization was required for the majority of thepatients (70, 93%), with a third necessitating intensive care unit (ICU) care. The necessity for surgical procedures was high at 57 (76%). Upon discharge, 8 (11%) patients were moved to acute rehabilitation. Injuries to the extremities were most common, accounting for 21% (36) of cases, in contrast to facial injuries at 8% (15). Upper extremity fractures were the most prevalent presenting injury at 31% (50), while lower extremity fractures were the least at 6% (9). The overall Injury Severity Score (ISS) averaged 12, with patients having hospital length of stays (LOSs) over 10 days presenting higher ISS scores (18) compared to those with shorter stays (ISS of 11). There was no significant difference in ISS between patients aged 60 and above compared to younger patients. Conclusions FFRs represent a substantial cause of injury in both the construction industry and residential settings. This study aims to provide an overview and summary of the existing literature on FFRs, present effective fall prevention methods, and underscore the considerable consequences of such injuries on both construction workers and homeowners. Additionally, it includes an analysis of a dataset detailing injuries resulting from roof-related falls, offering a comparison to existing research.

The Outcome of Total Hip Arthroplasty Without Subtrochanteric Shortening Osteotomy in Severe Developmental Dysplasia of the Hip

Background: Total hip arthroplasty (THA) is a surgical technique to correct developmental dysplasia of the hip (DDH). Various THA-based methods have been developed for managing end-stage osteoarthritis in patients with DDH Crowe type III or IV. Objectives: In this study, we evaluate the Harris hip score (HHS) before and after cementless THA without subtrochanteric shortening osteotomy (STO) in patients with DDH Crowe type III or IV who were candidates for THA, as well as complications and the need for revision surgery. Methods: This retrospective cohort study was conducted on patients with DDH Crowe type III and IV, who were candidates for cementless THA using the Watson Jones technique without shortening STO. The HHS was calculated and recorded in their medical files before surgery. Patients with missing or incomplete medical files, without written informed consent, with neurovascular diseases, immunosuppressive drug use, congenital bone and articular anomalies, low back pain radiating to the lower extremities, simultaneous fractures, a history of lower extremity fractures, or joint infections were excluded. The HHS was recalculated during outpatient follow-up. Neurovascular defects and the need for reoperation were also evaluated. All data were recorded and analyzed. Results: Thirty-two patients were enrolled with a mean ± SD age of 50.34 ± 15.45 years, most of whom were women (75%). The patients were followed for 2 to 7 years. Postoperative nerve defects were observed in only 1 (3.1%) patient. Hip reoperation was performed in 1 (3.1%) patient. The mean ± SD of HHS before surgery was 50.10 ± 12.48, which increased significantly to 77.99 ± 15.60 after surgery (P < 0.001). Furthermore, the HHS was evaluated before and after the intervention for each gender, showing a significant increase in both. Conclusions: Cementless THA without shortening osteotomy can improve HHS in patients with DDH Crowe III and IV, providing satisfactory outcomes. Furthermore, complications, such as neurological defects and the need for reoperation, are minimal with this method.

The association between lower limb fractures and weight gain in adults: a prospective analysis of body mass index trends

PurposeDespite understanding the connection between obesity and fracture risk, there is limited research on the implications of lower limb fractures on subsequent changes in body mass index (BMI). Our study aimed to assess the impact of lower limb fractures on BMI alterations over an 18-month period.MethodsA multi-center, prospective cohort study was conducted between January 2021 to June 2023, involving 494 adults with lower limb fractures. Participants were recruited within 2 weeks post-injury and were assessed for demographics, injury details, and weight at seven distinct time points. By 18 months, the primary outcome was the mean weight gain.ResultsThe average age of the participants was 39 (± 12.7) with a baseline weight and BMI of 80.4 kg and 27.6, respectively. At the 18-month follow-up, 75% of patients experienced an average weight increase in 4 kg (± 5.39 kg), equating to a BMI rise of 1.39 (± 1.88). Most patients attributed weight changes to their injury, with nearly half expressing distress from their weight change. Only 37% believed that they had resumed their previous activity levels by the final follow-up. Approximately 31% of the patients sought some form of external weight management care in the form of nutritionist advice, training programs, medication and weight management procedures.ConclusionsLower limb fractures significantly affect weight gain over an 18-month period, with substantial psychological and physical consequences. Healthcare providers should anticipate potential weight gain post-fracture and incorporate strategies addressing both physical and mental aspects of rehabilitation to enhance recovery outcomes. Early and even immediate weight bearing may play a pivotal role in mitigating weight changes and returning the patient to their previous level of activity. Further detailed studies focusing on different fractures and postoperative interventions are recommended.

Association of sex and aspirin use with postoperative bleeding in patients with lower extremity long bone fractures

ObjectiveThe perioperative management of patients on antiplatelet drugs is a rising challenge in orthopedic trauma because antiplatelet drugs are frequently encountered and carry an increased risk of hemorrhagic consequences. The...

Refinement in Post-Operative Care for Orthopaedic Models: Implementing a Sheep Walking Cast (SWC) for Effective Tibial Fracture Management.

In the healthcare system, lower leg fractures remain relevant, incurring costs related to surgical treatment, hospitalization, and rehabilitation. The duration of treatment may vary depending on the individual case and its severity. Casting as a post-surgical fracture treatment is a common method in human and experimental veterinary medicine. Despite the high importance of sheep in preclinical testing materials for osteosynthesis, there is no standardised cast system ensuring proper stabilisation and functionality of hind limbs during the healing of tibia fractures or defects. Existing treatment approaches for tibial osteosynthesis in laboratory animal science include sling hanging, external fixators, or former Achilles tendon incision. These methods restrict animal movement for 4-6 weeks, limit species-typical behaviour, and impact social interactions. Our pilot study introduces a Standardised Walking Cast (SWC) for sheep, enabling immediate physiological movement post surgery. Seven Rhone sheep (female, 63.5 kg ± 6.45 kg) each with a single tibia defect (6 mm mechanical drilled defect) underwent SWC application for 4 weeks after plate osteosynthesis. The animals bore weight on their operated leg from day one, exhibiting slight lameness (grade 1-2 out of 5). Individual step lengths showed good uniformity (average deviation: 0.89 cm). Group housing successfully started on day three after surgery. Weekly X-rays and cast changes ensured proper placement, depicting the healing process. This study demonstrates the feasibility of using an SWC for up to 72 kg of body weight without sling hanging via ceiling mounting or external fixation techniques. Allowing species-typical movement and social behaviour can significantly improve the physiological behaviour of sheep in experiments, contributing to refinement.

Association of Calcium and Vitamin D Supplements with Fractures in Persons with a Traumatic SCI.

Osteoporotic fractures occur in almost half of patients with a spinal cord injury (SCI) and are associated with significant morbidity and excess mortality. Paralyzed Veterans Administration (PVA) guidelines suggest that adequate calcium and vitamin D intake is important for skeletal health, however, the association of these supplements with osteoporotic fracture risk is unclear. To determine the association of filled prescriptions for calcium and vitamin D with fracture risk in Veterans with an SCI. The 5897 persons with a traumatic SCI of at least 2 years' duration (96% male; 4% female) included in the VSSC SCI/D Registry in FY2014 were followed from FY2014 to FY2020 for incident upper and lower extremity fractures. Filled daily prescriptions for calcium or vitamin D supplements for ≥6 months with an adherence ≥80% were examined. Filled prescriptions for calcium (hazard ratio [HR] 0.65; 95% CI, 0.54-0.78) and vitamin D (HR 0.33; 95% CI, 0.29-0.38) supplements were associated with a significantly decreased risk for incident fractures. Calcium and vitamin D supplements are associated with decreased risk of fracture, supporting PVA guidelines that calcium and vitamin D intake are important for skeletal health in persons with an SCI.

Clinical efficacy analysis of ultrasonic conductivity instrument combined with external application of xiaozhongsan in improving limb swelling and functional recovery of lower tibial fracture.

Clinical efficacy analysis of ultrasonic conductivity instrument combined with external application of xiaozhongsan in improving limb swelling and functional recovery of lower tibial fracture.

Rheumatoid arthritis, disease-modifying antirheumatic drugs and risk of major osteoporotic fracture: prospective data from the HUNT Study, Norway

ObjectivesRheumatoid arthritis has been associated with increased fracture risk. New treatments have improved the course of the disease substantially, but it is not clear if this influences fracture risk. We...

Selection Of Treatment Methods For Patients With Multiple Fractures Of Lower Extremity Bones

The aim of the study is to improve the results of treatment of patients with multiple lower extremity fractures by optimizing complex diagnostics and minimally invasive methods of external and internal fixation. The experience of treating 220 patients with multiple fractures of the long bones of the lower extremities in the clinic of the Republican Scientific and Practical Center of Traumatology and Orthopedics from 2016 to 2022 is presented.

Epidemiology and Sex-Specific Analysis of Basketball-Related Lower Extremity Fractures: A 10-Year Analysis of National Injury Data.

Basketball-related fractures involving the lower extremities frequently present to emergency departments (ED) in the United States (US). This study aimed to identify the primary mechanisms, distribution, and trends of these injuries. We hypothesize that (1) lower extremity fracture frequency will decrease from 2013 to 2022, (2) the ankle will be the most common fracture site, and (3) noncontact twisting will be the most common injury mechanism. Descriptive epidemiological. Level 3. The National Electronic Injury Surveillance System (NEISS) was queried for lower extremity fractures from basketball presenting to US EDs from January 1, 2013 to December 31, 2022. Patient demographics, injury location, and disposition were recorded. The injury mechanism was characterized using the provided narrative. National estimates (NEs) were calculated using the NEISS statistical sample weight. Injury trends were evaluated by linear regression. There were 6259 cases (NE: 185,836) of basketball-related lower extremity fractures. Linear regression analysis of annual trends demonstrated a significant decrease in lower extremity fractures over the study period (2013-2022: P = 0.01; R2 = 0.64). The most common injury mechanism was a noncontact twisting motion (NE: 49,897, 26.9%) followed by jumping (NE: 39,613, 21.3%). The ankle was the most common fracture site (NE: 69,936, 37.6%) followed by the foot (NE: 49,229, 26.49%). While ankle and foot fractures decreased significantly (P < 0.05), fractures of the lower leg, knee, toe, and upper leg showed no significant trends (P = 0.09, 0.75, 0.07, and 0.85, respectively). Basketball-related lower extremity fractures decreased from 2013 to 2022, with the ankle being the most common fracture site and most fractures arising from a noncontact twist. Increasing utilization of outpatient clinics may have contributed to the decline, particularly for ankle and foot fractures. The prevalence of ankle fractures and twisting-related injuries reinforces the importance of protective footwear and targeted strengthening protocols.

Unconventional mobility, conventional trauma: a comparative analysis of e-scooter-related fractures.

The present research aimed to compare the different types of fractures to those caused by e-scooter use as well as reveal the severity of e-scooter injuries via an epidemiological analysis of fractures over the course of 6months. This retrospective study assessed medical records of patients with fractures or dislocations admitted to a Turkish level three trauma centre emergency orthopaedic department between June 2021 and January 2022. Using a two-group design, the first group encompassed all fractures and dislocations treated, while the second focused on e-scooter-related cases. Comparative analysis covered fracture patterns and factors within the e-scooter group, like demographics, injury mechanism, and timing. Surgical need and types were explored for e-scooter injuries. Among 4481 upper extremity fractures, finger fractures (27.47%) and distal radius fractures (25.37%) were common, while e-scooter-related cases exhibited radius and ulna shaft fractures (23.07%). Of 2400 lower extremity fractures, toe fractures (30.2%) and metatarsal fractures (19.66%) predominated, with e-scooter-related injuries largely featuring metatarsal fractures (30%). The surgery rate in all patients was 8.92%, whereas the surgery rate specifically for e-scooter injuries was 48.2%. Significantly greater occurrence of lower extremity fractures was evident in e-scooter-related injuries compared to upper extremities (p = 0.011). Collisions involving stationary or moving objects were linked to injuries in the lower extremities, whereas falls were primarily associated with injuries in the upper extremities. Treatment included surgery (48.2%) and conservative management (52.8%), with ORIF (35.7%) and CRIF (10.7%) utilised. E-scooter-related fractures and dislocations are typically more severe, often requiring surgery, compared to other fractures during the same period. The study emphasises the link between injury type and increased risk of lower extremity fractures or dislocations.

Stability of One-Step Spray-on Splint for Lower Extremity Fractures During Splinting, MEDEVAC, and Impact.

Military transport can induce whole-body vibrations, and combat almost always involves high impact between lower extremities and the ground. Therefore, robust splinting technology is necessary for lower extremity fractures in these settings. Our team compared a novel one-step spray-on foam splint (FastCast) to the current military standard structured aluminum malleable (SAM) splint. Ten cadaveric specimens were subjected to complete tibia/fibula osteotomy. Specimens were fitted with custom accelerometer and gyroscope sensors superior and inferior to the fracture line. Each specimen underwent fracture and splinting from a standard of care SAM splint and an experimental FastCast spray foam splint in a randomized order. Each specimen was manually transported to an ambulance and then released from a 1 meter height to simulate impact. The custom sensors recorded accelerations and rotations throughout each event. Repeated-measures Friedman tests were used to assess differences between splint method within each event and between sensors within each splint method. During splinting, overall summation of change and difference of change between sensors for accelerations and rotations were greater for SAM splints than FastCast across all axes (P ≤ 0.03). During transport, the range of acceleration along the linear superior/inferior axis was greater for SAM splint than FastCast (P = 0.02), as was the range of rotation along the transverse plane (P < 0.01). On impact, the summation of change observed was greater for SAM splint than FastCast with respect to acceleration and rotation on the posterior/anterior and superior/inferior axes (P ≤ 0.03), and the cumulative difference between superior and inferior sensors was greater for SAM than FastCast with respect to anterior-axis rotation (P < 0.05). FastCast maintains stabilization of fractured lower extremities during transport and impacts to a significantly greater extent than SAM splints. Therefore, FastCast can potentially reduce the risk of fracture complications following physical stressors associated with combat and extraction.

An automatic segmentation algorithm for conglutinated bone fragments in 3D CT images of lower limb fractures based on morphology

An automatic segmentation algorithm for conglutinated bone fragments in 3D CT images of lower limb fractures based on morphology

Effects of carbon/glass nonwoven interleaving veils and their areal density on opening and shearing mode interlaminar fracture toughness of glass epoxy composites

The study explores the impact of Carbon and Glass nonwoven interleaving veils with varying areal density on delamination resistance in unidirectional (UD) Glass epoxy composites under Opening (Mode-I) and Shearing (Mode-II) mode loadings. Commercially available non-woven Carbon and Glass interleaves with areal densities of 15, 20, 25, and 30 g/m2 were used to manufacture the interleaved Glass epoxy laminates. Double Cantilever Beam (DCB) and End Notch Flexural (ENF) specimens were used to determine the mode-I and mode-II fracture energies. The results reveal that, during mode-I initiation, interleaved laminates exhibit a lower interlaminar fracture toughness (IFT) except for the Carbon fiber interleaved laminates of areal density 30 g/m2. However, during propagation, all veils interleaved laminates presented significant improvement in IFT ranging from 5 to 25 % accompanied by substantial fiber bridging. In case of mode-II test, the laminates with Carbon and Glass veils exhibit enhanced IFT (60–182 %) with increasing areal density compared with the non-interleaved Glass laminates. Optical and scanning electron micrographs (SEM) provide evidence of fracture mechanisms involved in the interleaved and non-interleaved composite laminates.

Mendelian-randomization study revealed causal relationship between nonalcoholic fatty liver disease and osteoporosis/fractures.

Patients with nonalcoholic fatty liver disease (NAFLD) are reported to have a higher risk of osteoporosis/fractures; however, the causal relationship remains unclear. Publicly available genome-wide association studies (GWASs) were used for Mendelian randomization (MR) analysis. GWASs of NAFLD and fractures were obtained from the FinnGen Consortium. GWASs of bone mineral density (BMD) were derived from a meta-analysis. GWASs of obesity, diabetes, liver function, and serum lipid-related metrics were used to clarify whether the accompanying NAFLD symptoms contributed to fractures. Moreover, two additional GWASs of NAFLD were applied. A causal association was not observed between NAFLD and BMD using GWASs from the FinnGen Consortium. However, a causal relationship between NAFLD and femoral neck-BMD (FN-BMD), a suggestive relationship between fibrosis and FN-BMD, and between NAFLD and osteoporosis were identified in replication GWASs. Genetically proxied body mass index (BMI), high-density lipoprotein (HDL), and hip circumference increased the likelihood of lower limb fractures. The waist-to-hip ratio decreased, whereas glycated hemoglobin (HbA1C) and homeostasis model assessment of β-cell function (HOMA-B) increased the risk of forearm fractures. Low-density lipoprotein (LDL) reduced, whereas HbA1C increased the incidence of femoral fractures. Alkaline phosphatase (ALP) raised the risk of foot fractures. However, after a multivariate MR analysis (adjusted for BMI), all the relationships became insignificant. NAFLD caused reduced BMD, and genetically predicted HDL, LDL, HbA1C, HOMA-B, ALP, hip circumference, and waist-to-hip ratio causally increased the risk of fractures. BMI may mediate causal relationships. Larger GWASs are required to verify this finding.

Effect of long-term aging on the microstructure evolution and fracture mechanism of 9% Cr steels

The fracture toughness of pressure pipe steels is vital for their design and safe operation. Understanding the deterioration of the fracture toughness and the corresponding fracture mechanisms is instructive and meaningful for material selection and development. The elastic–plastic fracture toughness of 9% Cr steels aged at 873 K and 923 K from the initial state to 20000 h was investigated at ambient temperature and 873 K. The deterioration of the fracture toughness and the corresponding fracture mechanisms are discussed in detail. For 9% Cr steels, voids mainly initiated from primary inclusions such as silicides, sulfides, alumina and manganides in as-received state, while voids initiated from both primary inclusions and secondary particles such as the Laves phase after long-term aging. These voids grew and coalesced with neighboring voids and crack tips subsequently until ultimately fracture. After aging at 873 K, the fracture toughness values tested at 873 K decreased from the initial state to 3000 h and then increased to 10000 h. The peculiar deterioration of the fracture properties after 3000 h of aging at 873 K can be attributed to the high number density of Laves phase particles in the steels. It was found that the densely distributed hard Laves phase particles induced strain concentration at the interface between the Laves phase and the matrix under plane-strain tension condition and promoted nucleation of voids. It was suggested that the spatial distribution of the Laves phase played a significant role on the void formation. 9% Cr steels with a denser distribution of Laves phases brings about voids with shorter interspaces, which are more susceptible to coalesce into crack tip, resulting in lower fracture resistance. After aging at 923 K from 10000 h to 20000 h, the number density, size and volume fraction of precipitates, block size, misorientation angle and dislocation density remained almost constant. The slight increase in the fracture toughness from 10000 h to 20000 h can be mainly ascribed to the coarsening of the martensite lath in this stage.

Clinical Application and Evaluation of Specialised Ring Fixators for the Management of Upper and Lower Limb Bone Fractures in Dogs

Present study was conducted on nine-clinical cases of humerus (n=4), femur (n=3) and radius-ulna (n=2) fractures in dogs of either sex, weighing 5.5 to 18 kg. Both closed (n=6) and open (n=3) fractures were treated in this study. The fracture was reduced and stabilized by transfixation using modified ring fixators. Semicircular (n=4) and hybrid fixators (n=5) were used for upper limb and lower limb bones respectively. The main component of fixator i.e. aluminium rings were designed locally at Bikaner using 4-mm aluminium sheets and fabricated accordingly. Full rings were used for distal radial (n=2) and distal femoral (n=1) fractures whereas semicircular rings were made through cutting the full ring during surgery for specific humeral (n=4) and femoral (n=2) fractures. Specialised wire fixation bolt (iron based; weighing 5.5g) was also designed locally at Bikaner for transcortical pin and ring articulation. Humeral and distal femoral fractures are challenging while bone plating of distal radial fracture demands further surgeries therefore external fixators were modified and applied in present study. Operated limbs were evaluated clinically with serial postoperative radiographs at regular intervals. Fixator-assembly evaluation and functional recovery of operated limbs were considered as objectives of this study.

The initial response of a local hospital in the earthquake zone during the February 6, 2023 Kahramanmaraş earthquakes: Injuries and challenges.

This study aimed to describe the type and number of traumatic injuries seen after devastating earthquakes and to evaluate the difficulties experienced in the treatment process in a primary affected center. Out of the 2176 patients who were treated in the emergency department, 372 (199 male and 173 female) patients with complete data were included in this single-center retrospective study. In addition to the demographic characteristics of the patients, orthopedic injuries, other organ system injuries, type of injury, treatments, mechanisms of injury, and time of presentation to the emergency department were recorded. The most common age group for injury was 20-30 years old, consisting of 73 patients (19.62%), and the second most common age group was between 40 and 50, with 72 patients (19.35%). Injury after being trapped under rubble was seen in 152 (40.86%) patients, while non-debris causes were more common in 220 patients (59.14%). The most common site of injury was in the lower extremities, with 111 patients (29.84%), while multiple injuries were seen in 109 patients (29.3%). Lower extremity fractures were mostly seen in long bones such as the femur (12.28%) and tibia (11.4%). Upper extremity fractures, especially those due to falls, were most frequently in the distal radius (8.77%). After triage, 117 patients (31.45%) were hospitalized, whereas the majority of patients (58.33%) were discharged from the emergency department. This study has shown us that injuries following major earthquakes are of a wide spectrum and occur in large numbers and in a very short time. Even in a well-equipped hospital that is not affected by an earthquake, there are many barriers to appropriate management. The first 24 hours after an earthquake are critical. This period should be kept in mind while organizing and taking necessary precautions, and early responses to earthquakes should be meticulously planned.

Ankle arthroscopy does not elevate complication rates in ankle fractures

IntroductionAnkle fractures rank as the second most common lower limb fractures, and surgical intervention is essential for unstable ankle fractures. The use of ankle arthroscopy in such cases offers several advantages. This study aim is to assess whether arthroscopy influenced on complication rates in 171 ankle fractures treated with arthroscopic assistance. MethodsThis retrospective epidemiological analysis encompassed adult ankle fractures between December 2018 and December 2021. Initially, 173 patients were considered, but two were excluded, leaving a final sample of 171 patients. Postoperative complications were categorized as major or minor. ResultsThe study included 171 patients with surgically treated ankle fractures assisted by arthroscopy, comprising 76 females and 95 males, with an average age of 41.9 years. Syndesmosis injuries were treated in all diagnosed cases (55.0%), and deltoid ligament injuries received attention when identified (33.7%). Arthroscopic techniques were preferred over open techniques (47.4%). Ten patients experienced complications, consisting of 2 major and 8 minor complications (5.8%). DiscussionOur study's epidemiological findings align with prior literature, demonstrating that intra-articular injuries accompany 63% to 79% of ankle fractures. Arthroscopy allows for both diagnosis and treatment within the same procedure, including joint lavage to reduce inflammation. We diagnosed 57 deltoid injuries and identified a statistical relationship between chondral, syndesmotic, and deltoid ligament injuries. Infection is a common complication in ankle fracture surgery, with rates ranging from 1.44% to 16%. Our study yielded a 5.8% complication rate, comprising 1.2% major and 4.6% minor complications. Patients undergoing ORIF with arthroscopic assistance had a lower prevalence of infection. ConclusionThe use of arthroscopic assistance in the surgical treatment of ankle fractures does not increase the overall complication rate. Level of evidenceIV