THE RESULTS OF EARLY SURGICAL INTERVENTION FOR INITIAL SUBOPTIMAL ANKLE FRACTURE FIXATION

Abstract

Ankle fractures are common injuries and commonly require operative stabilisation. The aim of treatment should be anatomical reduction as this will lead to good long-term results. Non-anatomically reduced fractures will lead to a poor functional outcome and development of osteoarthritis. Our aim was to determine whether revision of non-anatomical fixations within 12 months of initial surgery improved outcome.

We present eight cases of non-anatomical ankle fixations that were revised by the senior author over a 4-year period. There were 4 females and 4 males. The mean age was 45.6 years at review (range 28–63) and the mean time from initial fixation to revision was 5.25 months (range 2–11). Mean time at review was 26.6 months (range 7–45). Clinical scoring for functional outcome was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) rating system for the ankle and hindfoot. Mean AOFAS score prior to revision was 40 (range 19–69) and the mean score at review was 80 (range 54–100).

All patients reported benefit in terms of function from the revision procedure. The aim of initial surgery is for anatomical reduction of the ankle joint. Should suboptimal fixation be encountered within 12 months of the initial surgery, we feel revision surgery is justified.