Author(s): Hemanth H. P1, Abhijit Patil2, Darshan M. S3

Ankle fractures are among the most common injuries treated by orthopaedic surgeons. However, very few investigators have examined the functional recovery following operative treatment of ankle fractures. Anatomic restoration with open reduction and internal fixation is the goal of management in ankle fractures. The purpose of this study is to analyse the functional outcome following operative treatment of ankle fractures using subjective as well as objective criteria.
90 patients with ankle fractures who fulfilled the inclusion criteria were included in the study. All patients underwent surgical fixation of the fractures. The follow-up assessment which consisted of subjective (Pain, Walking, Activity, Radiographs, Ankle and Subtalar Joint Function) and objective (Olerud and Molander Ankle Score) evaluations, were performed at 6 weeks, 3 months and 6 months postoperatively.
Out of 90 patients, the commonest injury pattern seen was supination-external rotation, followed by supination-adduction. The most common modality of fixation for the lateral malleolus was 1/3rd tubular plate and for the medial malleolus was 4 mm cannulated cancellous screws with washer. Syndesmotic screws were not applied in any of the cases. At 6 weeks follow-up 40% (n=36) had complications of persistent swelling, residual pain. We found a statistically significant improvement in the subjective assessment of pain, walking, activity levels, ankle and subtalar joint function from 3rd month to 6th month postoperatively. However, subjective radiographic assessment failed to show any statistically significant improvement. The mean Olerud and Molander Ankle Score was statistically significant 47.5±19.7 at 3rd month post-op and, 81.7±16.2 at 6th month post-op. Age was a significant predictor of final outcome, with younger patients having a better functional outcome.
Operative treatment for ankle fractures results in good functional outcome postoperatively. Anatomical reduction of the fracture is associated with better functional outcome. Early treatment without delay, anatomic reduction and fracture fixation, stringent postoperative mobilisation and rehabilitation should help improve outcome in an operated ankle fracture.

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