Ankle Fractures: The Operative Outcome (original) (raw)
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Assessment of operative outcome of ankle fractures: A clinical study
International Journal of Orthopaedics Sciences, 2021
Background: Ankle fractures are one of the most common fractures presenting in public hospitals. Most of the studies report the short term functional outcome post-ankle fracture surgery. Hence; the present study was undertaken for assessing operative outcome of ankle fractures. Materials and methods: A total of 40 patients operatively treated for an unstable ankle fracture were entered into a database and prospectively followed. The postoperative protocol was standardized for all patients. Complete demographic and clinical details of all the patients were obtained. Baseline characteristics, complications, additional surgery, functional status and the American Orthopaedic Foot and Ankle Society score (AOFAS) were assessed. The intervention chosen was open reduction and internal fixation of unstable ankle fractures. Functional outcome was evaluated. Results: Level of pain decreased consistently over the 3-, 6-, and 12-month follow-up periods in both study groups as measured by the AOFAS questionnaire. At 3 months, 6 months and 12 months followup, mean AOFAS score was 75.5, 80.3 and 85.3 respectively. Conclusion: Patients undergoing operative fixation of unstable ankle fractures showed reasonable functional result at the 1-year follow-up.
Unsatisfactory outcome following surgical intervention of ankle fractures
Foot and Ankle Surgery
The aim of this study was to evaluate outcome after surgical intervention in patients with ankle fractures. Fifty-four patients consecutively operated were included. A standardised protocol was used to record a number of variables regarding patient characteristics, type of fracture and treatment. Radiographic examination was performed in all patients postoperatively and after 14 months. A questionnaire containing the Olerud–Molander Ankle Score (OMAS) and some supplementary questions was used 14 months and 3 years after surgery. The median OMAS was 75 at the 14-month and 85 at the 3-year follow-up. Patients !40 years of age scored significantly better. Only 50% returned to the same activity level 14 months after injury. Pain, stiffness and swelling were present among more than half of the patients and 40% reported instability and problems when using stairs. In conclusion, subjective outcome 3 years after surgical intervention for ankle fractures is poorer than expected.
Ankle Fractures: Review Article
Journal of Arthritis, 2015
Ankle fractures are a common injury associated with trauma in the young patient and osteoporosis in the elderly patient. They can be associated with significant morbidity and challenging to manage. These patients are at an increased risk of developing post traumatic ankle arthritis as well as other complications. Therefore a systematic approach to the management of ankle fractures is required. We review the anatomy, clinical presentation and discuss the management options and potential complications commonly encountered in these injuries.
Ankle Fractures in the Elderly
Journal of Orthopaedic Trauma, 2005
This study was performed to determine 1) the rate of ankle fractures in the elderly in the United States stratified by hospital referral region, and 2) whether the percentage of ankle fractures treated surgically is affected by factors, such as fracture location, hospital referral region, concentration of orthopaedists, presence of a teaching hospital in that region, patient age, race, gender, or the number and type of specific medical comorbidities. Design: A 20% sample of Medicare Part B claims from the years 1998 to 2000 was analyzed. Patients/Intervention: The CPT codes for operative and nonoperative treatment of isolated medial malleolar, isolated lateral malleolar, bimalleolar, and trimalleolar fractures were identified. These codes were used to determine the overall rate of ankle fractures and individual fracture types. Main Outcome Measurement: The rate of ankle fractures was evaluated by hospital referral region, patient age (groups of 5 years, aged 65 years or older), gender, and race. The percentage of surgical treatment was determined for each fracture type as the number of surgically treated fractures over the total number of ankle fractures within each subtype and analyzed by fracture type, hospital referral region, and concentration of orthopaedists in that region, presence of a teaching hospital within the hospital service area, patient age, gender, race, and number and type of specific medical comorbidities. Regression was performed by using the above variables. Results: We identified 33,704 ankle fractures: 7.6% were isolated medial malleolar, 50.8% were isolated lateral malleolar, 27.4% were bimalleolar, and 14.2% were trimalleolar fractures. The overall United States average was 4.2 ankle fractures per 1000 Medicare enrollees. The rate of ankle fractures varied by a factor of 8, from 1 per 1000 Medicare enrollees in San Francisco, CA, to 8.3 in Hickory, NC. The rate of ankle fractures was highest in white women at 5.8 and lowest in nonwhite men at 1.5 per 1000 Medicare enrollees. The overall rate of ankle fractures that underwent surgical stabilization was 33%, ranging from 14% in Binghampton, NY, to 72% in Napa, CA. The rate of surgical intervention was 22% for isolated medial
A comparative study on Early versus Delayed Operative Treatment of Closed Ankle fracture in Adults
IOSR Journals , 2019
Background: An Ankle fractures are one of the most common lower limb fractures; they account for 9% of all fractures, representing a significant portion of the trauma workload. Ankle fractures usually affect young men and older women, however, below the age of 50; ankle fractures are the commonest in men. Timely treatment intervention is a crucial factor for appropriate wound healing and early rehabilitations. Sometimes due to lack of hospital facility in far flung area or some other reasons patient come to hospital late. So for orthopaedic surgeon it has become important to know the outcome of operative treatment done late. Materials and method: It is a Hospital based Quasi-experimental study conducted on 30 patients for a period of 2 years from September 2017 to October 2019 in the Department of Orthopaedics RIMS, Imphal, Manipur to compare the outcome of early versus delayed operative treatment of closed ankle fracture in terms of infection, post operative hospital stay, fracture union, range of motion, weight bearing and functional outcome of the limb. Patients fulfilling the inclusion criteria and willing to take part in the study were included and divided by purposive sampling into 15 each in two groups namely early group: where the patients were treated within one week of injury, and delayed group: where the patients were treated after one week of injury. Post operative evaluations of functional and radiological outcome was done using Olerud C and Molander H functionl score system on the basis of poor, fair, good and excellent. And the two groups were compared using Independent t_ test and Chi-square test. Difference was considered statistically significant when the value was < 0.05. Results: In early group there was excellent functional outcome in 9 cases (60 %), good in 3 cases (20%), fair in 2 cases (13.3%) and poor in 1 case (6.6%). In delayed group there was excellent functional outcome in 8 cases (53.3%), good in 3 cases (20%), fair in 3 cases (20%) and poor in 1 case (6.6%). Both the groups was comparable as the p value was >0.05. Discussion: In this comparative study, the differences between the results of early and late operative treatment of closed ankle fracture in adults were insignificant in terms of fracture union, range of motion, weight bearing, operative time and functional outcome. Both groups had 100% union rate without any failure. There were statistically significant difference in terms of post operative hospital stay and wound infections which showed lesser complication in early group leading to lesser post operative hospital stay. Conclusion: In this study the overall functional outcome was 80 % excellent to good results in early group and 73.3 % excellent to good results in delayed group. Thus when immediate fixation is not possible, delayed fixation of displaced ankle fracture is a reasonable option.
Ankle Fractures in the Elderly: Initial and Long-term Outcomes
Foot & Ankle International, 2008
Background: Surgical management of ankle fractures will be an increasing part of the orthopaedic practice for aging adults. To date, there are few studies comparing outcomes after ankle fracture surgery between patients over and under 65 years. The purpose of this study was to evaluate short- and long-term outcomes after surgical treatment of isolated malleolar fractures in both the elderly and non-elderly population. Materials and Methods: Charts and radiographs were reviewed for 25 patients over age 65 and 46 patients under age 65 who underwent operative treatment of an ankle fracture during a 2-year period. Postoperative complications and need for placement in a skilled nursing facility following discharge were noted. The SF-36 and the Olerud and Molander Ankle Score were completed. Mean duration of followup in patients greater than 65 was 27 months and 24 months for patients less than or equal to 65 years. Results: Patients over 65 had a higher number of postoperative complicati...
Journal of Orthopaedic Trauma, 2019
Objectives: The goal of this study was to describe current practice patterns of orthopaedic trauma experts regarding the management of ankle fractures, to review the current literature, and to provide recommendations for care based on a standardized grading system. Design: Web-based survey Participants: Orthopaedic Trauma Association (OTA) members Methods: A 27-item web-based questionnaire was advertised to members of the OTA. Using a cross-sectional survey study design, we evaluated the preferences in diagnosis and treatment of ankle fractures. Results: One hundred and sixty-six of 1967 OTA members (8.4%) completed the survey (16% of active members). There is considerable variability in the preferred method of diagnosis and treatment of ankle fractures among the members surveyed. The majority of responses are in keeping with best evidence available. Conclusions: Current controversy remains in the management of ankle fractures. This is reflected in the treatment preferences of the OTA members who responded to this survey.
Result of Ankle Fracture Fixation, Our Hospital Experience
Journal of Pharmaceutical Research International, 2021
Aims and Objectives: The goal of this study was to see the outcome of open reduction and internal fixation for ankle fractures. Methods: A prospective analysis of 40 ankle fractures of adult patients handled surgically using diverse approaches in the period from January 2019 to January 2020 at the Orthopedic department of SMBBIT, Dow University of Medical and Health Sciences. Karachi Pakistan. The ankle grading system developed by Baird and Jackson was used to assess the functional result. Results: We achieved 87.5 percent outstanding to good outcomes, 6.3 percent fair outcomes, and 6.2 percent bad outcomes in our study. The findings were comparable to those of other researchers around the world. Interpretation and Conclusion: In 87.5 percent of patients, the operational results were satisfactory, with good to outstanding functional outcomes. With stable fracture fixation, excellent outcomes are attained. Cancellous screws are better for internal fixation of the medial malleolus, wh...