Long-term functional and radiographic outcomes in 243 operated ankle fractures

Journal of Foot and Ankle Research

J. M. Hoogendoorn²  I. B. Schipper¹  S. M. Verhage² 

[1] Department of Trauma-surgery, Leiden University Medical Center, Leiden, The Netherlands;MC Haaglanden, Department of Surgery, The Hague, 2501 CK, The Netherlands

关键词: Patient outcome assessment;    Trimalleolar fracture;    Bone fracture;    Ankle;   

Others  :  1224852
DOI  :  10.1186/s13047-015-0098-1

 received in 2015-01-04, accepted in 2015-08-06,  发布年份 2015

【 摘 要 】

Background

Large comparative studies that have evaluated long-term functional outcome of operatively treated ankle fractures are lacking. This study was performed to analyse the influence of several combinations of malleolar fractures on long-term functional outcome and development of osteoarthritis.

Methods

Retrospective cohort-study on operated (1995–2007) malleolar fractures. Results were assessed with use of the AAOS- and AOFAS-questionnaires, VAS-pain score, dorsiflexion restriction (range of motion) and osteoarthritis. Categorisation was determined using the number of malleoli involved.

Results

243 participants with a mean follow-up of 9.6 years were included. Significant differences for all outcomes were found between unimalleolar (isolated fibular) and bimalleolar (a combination of fibular and medial) fractures (AOFAS 97 vs 91, p = 0.035; AAOS 97 vs 90, p = 0.026; dorsiflexion restriction 2.8° vs 6.7°, p = 0.003). Outcomes after fibular fractures with an additional posterior fragment were similar to isolated fibular fractures. However, significant differences were found between unimalleolar and trimalleolar (a combination of lateral, medial and posterior) fractures (AOFAS 97 vs 88, p < 0.001; AAOS 97 vs 90, p = 0.003; VAS-pain 1.1 vs 2.3 p < 0.001; dorsiflexion restriction 2.9° vs 6.9°, p < 0.001). There was no significant difference in isolated fibular fractures with or without additional deltoid ligament injury. In addition, no functional differences were found between bimalleolar and trimalleolar fractures. Surprisingly, poor outcomes were found for isolated medial malleolar fractures. Development of osteoarthritis occurred mainly in trimalleolar fractures with a posterior fragment larger than 5 %.

Conclusions

The results of our study show that long-term functional outcome is strongly associated to medial malleolar fractures, isolated or as part of bi- or trimalleolar fractures. More cases of osteoarthritis are found in trimalleolar fractures.

【 授权许可】

   
2015 Verhage et al.

【 图 表 】

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