• Deirdre K Regan, Stephen Gould, Arthur Manoli, and Kenneth A Egol.
• *Department of Orthopaedic Surgery, Hospital for Joint Diseases, NYU Langone Medical Center, New York, NY; †UAB Department of Orthopaedic Surgery, UAB Orthopaedic Clinic, Birmingham, AL; and ‡Department of Orthopaedic Surgery, Jamaica Hospital Medical Center, Jamaica, NY.
• J Orthop Trauma. 2016 Jul 1; 30 (7): e236-41.

ObjectivesTo evaluate long-term clinical and radiographic outcomes after surgical fixation of unstable ankle fractures.DesignProspective follow-up study.SettingAcademic medical center with 2 Level-I trauma centers and a tertiary care center.PatientsOne hundred forty-one patients who underwent surgical repair of an unstable ankle fracture.InterventionOpen reduction internal fixation of an unstable ankle fracture.Main Outcome MeasurementsShort Musculoskeletal Function Assessment (SMFA) scores and radiographic outcomes based on the van Dijk criteria at a mean of 11.6 years follow-up.ResultsOf the 281 patients meeting the inclusion criteria for this study, follow-up data were obtained from 141 patients (50%), at a mean of 11.6 years after surgery. Overall, mean long-term SMFA scores were improved when compared with scores at 1 year. The American Society of Anesthesiologists class 1 or 2 was found to be a significant predictor of recovery based on SMFA scores. Sixty-three percent of follow-up radiographs demonstrated evidence of radiographic arthritis, including 31% with mild osteoarthritis, 22% with moderate osteoarthritis, and 10% with severe osteoarthritis. Fracture dislocation at injury was found to be a significant predictor of radiographic posttraumatic osteoarthritis at latest follow-up. One patient (0.7%) underwent a tibiotalar fusion secondary to symptomatic posttraumatic arthrosis. One patient (0.7%) underwent total ankle replacement due to severe osteoarthritis.ConclusionsOur data indicate that over a decade after ankle fracture fixation, most of the patients are doing well. Despite the presence of radiographic arthritis in 63% of patients, few experience pain or have restrictions in function, and mean long-term functional outcome scores are improved when compared with scores at 1 year. Patients undergoing operative fixation of unstable ankle fractures can anticipate functional outcomes that are maintained over time.Level Of EvidenceTherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

37 keywords...

hide…