• Conor Deasy, Diarmuid Murphy, Geraldine C McMahon, and Ian P Kelly.
• Department of Orthopaedics, Waterford Regional Hospital, Ireland. conordeasy@hotmail.com
• Eur J Emerg Med. 2005 Oct 1; 12 (5): 216-9.

ObjectiveThe aim of this study was to identify pitfalls in the acute management of ankle fractures which were referred to a regional orthopaedic unit. This unit provides orthopaedic services for the catchment area of the Waterford Emergency Department together with three additional emergency units in the south-eastern region of Ireland.MethodsThis is a retrospective study of all patients referred to the Waterford Regional Orthopaedic service from 1 January 2001 to 31 December 2001 for management of acute ankle fractures.ResultsA total of 236 patients were identified during the study period. Open reduction and internal fixation were performed in 200 cases. In all, 52% of patients had definitive surgery within 24 h of their injury. These patients were evenly distributed between regional (64%) and peripheral (60%) emergency unit referrals. 24% of patients required essential manipulation prior to surgery. This had been performed in only 34% of cases prior to transfer. Two patients were transferred with a pulseless foot.ConclusionsAnkle fractures are a common musculoskeletal injury seen in emergency departments and minor injury units. Long-term disability resulting from ankle fractures can be reduced by optimal early management procedures. This is an important area for consideration in education programmes in emergency medicine.

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