• Ulus Travma Acil Cer · Nov 2020

    The common comorbidities leading to poor clinical outcomes after the surgical treatment of ankle fracture-dislocations.

    • Mustafa Yalın, Furkan Çağlayan Aslantaş, Altuğ Duramaz, Mustafa Gökhan Bilgili, Emre Baca, and Alican Koluman.
    • Department of Orthopedics and Traumatology, Elazığ Training and Research Hospital, Elazığ-Turkey.
    • Ulus Travma Acil Cer. 2020 Nov 1; 26 (6): 943-950.

    BackgroundThe ankle fracture-dislocations are a significant traumatic incident for the bone and the soft tissue surrounding the ankle. Bone stabilization, joint immobilization, anatomic reduction and intervention for soft tissue protection should be performed as early as possible. The present study aims to determine the frequency of major comorbidities that can be seen after surgery in patients with ankle fracture-dislocations and the relationship between the trauma mechanism and clinical status with these comorbidities.MethodsThirty-eight patients (25 males, 13 females) who underwent surgery with ankle fracture-dislocations between May 2014 and February 2017 were evaluated retrospectively in this study. All patients were evaluated clinically and radiologically at least 24 months postoperatively. Arthrosis, synostosis, presence of the chondral lesion and AOFAS scores were detected for all patients.ResultsMean AOFAS score was lower in open ankle fracture-dislocations than in closed dislocations (p=0.044). An accompanying osteochondral lesion (OCL) and increased patient age were found to be strongly associated with the development of arthrosis (p=0.005 and p=0.017; respectively). Four of 29 patients who received primer definitive surgery and four of nine patients who received step-by-step surgery had poorly calculated AOFAS scores (p=0.071). There was no significant relationship between dislocation direction and AOFAS scores (p=0.087).ConclusionClinical and functional results were found to be worse in patients with open ankle fractures, the rate of arthrosis increased with age, and the use of syndesmosis screw had a positive but not a statistically significant effect on clinical and functional outcomes.

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