Elsevier

The Journal of Foot and Ankle Surgery

Volume 57, Issue 6, November–December 2018, Pages 1096-1100
The Journal of Foot and Ankle Surgery

Short-Term Outcomes and Influencing Factors After Ankle Fracture Surgery

https://doi.org/10.1053/j.jfas.2018.03.045Get rights and content

Abstract

The present study investigated the factors influencing the early clinical outcomes after ankle fracture surgery. We included 88 patients, who had undergone implant removal surgery at 1 year after ankle fracture surgery, with ankle computed tomographic (CT) scans obtained before ankle fracture surgery and at implant removal available. We collected demographic information, including age, sex, the presence of diabetes mellitus, level of trauma energy, and fracture classification from the medical records. We also recorded the fracture height using the radiographs and CT images. The medial joint space and articular incongruity were assessed on the follow-up radiographs and CT scans. Bone attenuation was measured by placing a circular region of interest around the ankle joint on the preoperative CT image. The postimplant removal outcomes were assessed using 2 functional questionnaires, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and Foot and Ankle Outcome Score (FAOS). Significant factors related to the AOFAS ankle-hindfoot scale scores and FAOS were identified through univariate analysis using age, sex, radiographic measurements, and CT findings as explanatory variables, followed by multiple regression analysis. On multiple regression analysis, the total FAOS was independently related to the AO classification (p = .003) and Lauge-Hansen classification (p = .003). The total AOFAS ankle-hindfoot scale score was related to articular incongruity (p = .044). The early clinical outcomes after ankle fracture surgery were affected by involvement of the ankle joint fracture rather than the lateral malleolus fracture height. Female sex and the presence of postoperative articular incongruity correlated with inferior early clinical outcomes.

Section snippets

Patients and Methods

The institutional review board of our hospital approved the present study and waived the requirement for informed consent owing to the retrospective nature of the present study. We also safeguarded protected health information related to the subjects whose infromation was used in the study. We reviewed the medical records of consecutive patients who had undergone open reduction and internal fixation of an ankle fracture, including lateral malleolar fractures, at our institution from January

Results

A total of 88 ankles from 88 patients were ultimately included in the present study. The mean patient age at fracture surgery was 47.8 ± 16.0 (range 16.2 to 75.3) years. The mean BMI was 24.3 ± 3.4 (range 18.8 to 34.9) kg/m2. The patient demographic data are listed in Table 1. The largest subsets of patients were those with a stage 2 injury using the LH classification and stage 1 injury using the AO classification (Table 2).

Of the independent variables, the function in daily life score

Discussion

Although many studies have investigated the clinical outcomes after ankle fractures, most studies have reported the outcomes for specific subgroups of ankle fractures. We performed the present study to evaluate the early clinical outcomes and investigate the factors influencing these outcomes after ankle fracture surgery using multiple regression analysis. We found that the total FAOS was affected by the AO and LH classifications and the total AOFAS ankle-hindfoot scale score was affected by

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    Financial Disclosure: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science and ICT (grant NRF-2016R1C1B2008557).

    Conflict of Interest: None reported.

    K.H.S. and S.-S.K. contributed equally to the writing of the present report.

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