Chronic Pain After Ankle Fracture: An Arthroscopic Assessment Case Series

Abstract

Synovitis and chondral damage were more frequent than arthrofibrosis and spurs. Synovitis and arthrofibrosis were found most frequently in the anterolateral aspect of the joint. Also, the higher the lateral malleolar fracture was in relation to the syndesmosis, the higher was the occurrence of talar chondral damage.

Arthroscopy-Assisted Surgery for Acute Ankle Fractures: A Systematic Review

“…They found that talar articular lesions had a strong relation with tibiofibular syndesmosis disruptions but not with deltoid ligament injuries. Similarly, Thomas et al 16 suggested that the more superior the lateral malleolar fractures were in relation to the syndesmosis, the higher the occurrence was of chondral damage to the talus. On the other hand, Ono et al 8 found that there was no correlation between fracture type and the sites of cartilaginous damage.…”

“…There is only an assumption that the standard treatment of chondral lesions is actually effective in reducing symptoms. 10 Except for 1 study that reported a high chondral lesion rate of up to 90%, 16 the rate of chondral lesions in chronic cases was reported to be between 3% and 33%. It was far lower than the rate reported in acute cases.…”

“…12, 16 Loren and Ferkel 12 analyzed 48 patients with acute unstable ankle fractures who underwent AORIF. They found that talar articular lesions had a strong relation with tibiofibular syndesmosis disruptions but not with deltoid ligament injuries.…”

“…6,16 Arthroscopic debridement of fibrous tissue could offer an effective method for improving articular function. Utsugi et al 6 reported that 27% of their patients had functional deterioration of the ankle joint after ORIF.…”

“…Arthroscopy-assisted open reductioneinternal fixation (AORIF) for the treatment of acute ankle fractures has also been reported. AORIF has several advantages in theory, including the following: An accurate and direct evaluation of the intra-articular injuries is provided without formal arthrotomy 2,8,[10][11][12][13][14] ; lavage and debridement of the ankle joint may help the postoperative range of motion recover more quickly 1,15,16 ; and the quality of the intra-articular reduction is assessed. 2,3,5,8,13,14 Although arthroscopy has been proved to be a powerful tool in managing many ankle diseases, 17,18 given the lack of clinical proof, Glazebrook et al 17 classified AORIF for acute ankle fractures as having "insufficient or conflicting evidence not allowing a recommendation for or against intervention.…”