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OUTCOME AFTER FIXATION OF ANKLE FRACTURES ACCORDING TO AO PRINCIPLES. IS A SUBJECTIVE FUNCTIONAL SCORING SYSTEM SUFFICIENT?

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Background Ankle fractures vary in the amount of displacement, damage to the articular surface and disruption of the ligamentous structures. The consequences of injury will vary according to the fracture pattern and the patient. When a patient sustains an injury we would like to know both the early and late result of treatment for that particular patient. There has been debate about the instrument to be used for this follow up.

The aim of the present study is firstly to determine the outcome after open reduction and internal fixation of ankle fractures using the AO/ASIF principles and secondly to determine if the modified version of the scoring system of Phillips et al was appropriate for early and late follow up.

Method Retrospective analysis of case notes and radiographs of patients requiring ORIF of an Ankle fracture between 01/01/98 to 30/03/00. The end date was chosen so that all patients had a minimum of one year followup.

Patients with incomplete follow up, notes and radiographs were excluded. Functional outcome was assessed using a modified version of the scoring system of Phillips et. al. This was sent to patients by post.

Results 106 patients were included in the study. 50 male and 56 female. Age ranged from 14 to 83 mean 47. There were 6 type A, 43 typeB and 59 type C fractures according to the Danis Weber system.

2 were open fractures. There were 5 patients with significant associated injuries. 29 patients had significant co-morbid conditions.

29 patients had surgery on the date of admission. The mean interval to surgery was 3 days.

Patients were followed up regularly in the Out patients clinic

Reduction of fracture was assessed on post operative radiographs using the criteria of Joy et al (1974).

66 patients returned the questionnaire and the functional outcome was determined for this group. 51 patients had an excellent result, 6 patients had a good result, 5 patients had a satisfactory result 4 patients had a poor result. Detailed outcome and complications will be presented in our paper.

Conclusions Fixation of Ankle fractures according to the AO/ASIF guidelines gives good results in the short term with acceptable rate of complications.

Subjective assessment is satisfactory for measuring early and late outcome after Ankle surgery.

No statistically significant factors affected outcome in our study.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.