DO UNDISPLACED STABLE ANKLE FRACTURES EVER DISPLACE – ARE WE SUBJECTING OUR PATIENTS TO UNNECESSARY RADIATION AND FOLLOW-UP APPOINTMENTS? SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST, ENGLAND

Abstract

Aim: To assess whether stable undisplaced ankle fractures treated conservatively with a below knee non weight bearing cast ever displace.

Methods: Retrospective case notes analysis was performed. Between August 2007 and August 2009, one hundred and twenty one patients sustained a stable undisplaced ankle fracture which was treated conservatively. Their age range was from 16 to 86 years. Male to female ratio was 74:47. The mean number of clinic follow ups was 3.7. These patients were classified according to the Danis-Weber Classification for analysis. Thirty (25%) patients had Weber A1 fractures, seventy two (60%) had Weber B1 fractures, five patients (4%) had Weber B2 fractures, three patients (2%) had Weber C1 fractures, ten patients (8%) had isolated medial malleolus fracture and one patient suffered an isolated posterior malleolus fracture.

Results: An average of 4.7 x-rays were performed on each patient from the time of diagnosis to discharge from clinic. None of these fractures displaced on follow up x-rays.

Conclusion: Stable undisplaced ankle fractures treated conservatively with a below knee non weight bearing cast do not displace. Hence these patients do not require to be followed up frequently with serial x-rays as they may be exposed to unnecessary harmful radiation and follow up appointments thereby saving time, money and resources.