Prognostic aspects in operated ankle fractures

Abstract

A long-term follow-up (3.5 years mean) of 106 operated ankle fractures out of 167 patients revealed 73.7% excellent and good, 16% acceptable and 10.3% poor results. Anatomically exact reduction was shown to be a prerequisite for good results and was seen in 77.2% of all cases. By neglecting biomechanical principles an insufficient reconstruction led to a poor final outcome. But even in 11% of the excellent operatively treated fractures late arthrosis developed. Statistical analysis showed that the onset of posttraumatic arthrosis was correlated with and predicted best by the number of single lesions. Dorsiflexion testing was the clinical parameter correlating best with the extent of the injury, the degree of arthrosis and the subjective complaints. This underlines the importance of assessment of dorsiflexion as a clinical screening test for remaining sequelae after ankle fractures.

Prediction of Outcome After Ankle Fracture

“…Other authors have reported similar findings. 4,6,13,27 The predictive value of other variables is not clear. Kennedy et al 13 found that an age of greater than 57 years predicted a poorer outcome after ankle fracture than an age of 57 years or less.…”

“…2,6,18,20,27 While no single outcome measure is uniformly used after ankle fracture, a combination of functional outcome questionnaires, subjective rating of recovery by the patient, and objective measures of impairment appears appropriate.…”

“…Only a few studies have previously investigated predictors of outcome after ankle fracture. Interpretation of these studies is limited due to methodological problems, including retrospective data collection, 4,10,13,14,27 poorly defined cohorts, 9,12 and high loss to followup. 4,13,14,27 Most studies fail to describe the predictive value of individual variables or combinations of variables.…”

“…Interpretation of these studies is limited due to methodological problems, including retrospective data collection, 4,10,13,14,27 poorly defined cohorts, 9,12 and high loss to followup. 4,13,14,27 Most studies fail to describe the predictive value of individual variables or combinations of variables. 4,6,10,13,14,27 Fracture classification is one variable that has been studied for its predictive value.…”

“…4,13,14,27 Most studies fail to describe the predictive value of individual variables or combinations of variables. 4,6,10,13,14,27 Fracture classification is one variable that has been studied for its predictive value. The 2 most commonly used classification systems (Weber and Lauge-Hansen) have not demonstrated significant predictive value.…”