Introduction: The purpose of this study is to identify significant differences in the clinical outcomes of patients who sustained a low energy trauma resulting into an ankle fracture-dislocation, treated with invasive (external fixation or skeletal traction) and conservative damage control procedures (closed reduction in plaster).
Materials and methods: This is a retrospective comparative study including 52 patients with low energy ankle fracture-dislocation, surgically treated between January 2015 and January 2017. Patients included in this study had a minimum 24 months follow-up (range 24-36 months). Patients were divided in 2 groups, group A (n = 21) initially treated with invasive damage control procedures to maintain reduction and group B (n = 31) treated with non-invasive damage control procedures. Patients were evaluated clinically and radiographically. Clinical assessment was performed by evaluating ankle range-of-motion and the Olerud - Molander ankle score at 6, 12 and 24 months as endpoints for both groups.
Results: Groups were assessed for homogeneity with a chi-squared test, and no statistical differences were found regarding Weber classification, type of dislocation, and Tscherne classification. A significant improvement in the Olerud-Molander score was noted between the 6- and 12-month follow-ups (p 0.01), but not between the 12- and 24-month follow-ups. This improvement was not observed between the 12 and 24 months follow-up. No statistically significant differences in the Olerud-Molander score were found between the two groups at both the 6- and 24-month follow-ups.
Conclusions: Closed reduction in plaster for fracture-dislocations of the ankle joint following low-energy trauma appears capable of maintaining reduction with outcomes comparable to more invasive damage control procedures.
Keywords: Ankle fractures; Damage control; Dislocations; Low energy trauma.
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