Operative fixation of ankle fractures is often deferred due to swelling to avoid the risk of wound problems. The routine practice is to admit the patient and operate once the swelling has subsided. We introduced a new pathway to manage these ankle fractures at home preoperatively to improve service efficiency. We studied the impact of home therapy on length of inpatient stay and associated problems. A control group was studied from December 2009 to March 2010, where patients were treated normally. The home therapy ankle pathway was then introduced in August 2010. Patients presenting with excess ankle swelling were placed in a back slab following reduction of ankle to a satisfactory position. The patients were provided limb care advice, thromboprophylaxis, an emergency contact number and discharged home on crutches with a predetermined operative slot, usually 6 days following injury. Patients were also contacted by a member of staff to ensure they were coping with the injured limb at home. Patients who are unsafe to be discharged on home therapy were admitted. This cohort of patients was studied between August 2010 and December 2011.Introduction
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