The functional outcome and quality of life after treatment of isolated medial malleolar fractures.

BACKGROUND

The optimal treatment of isolated medial malleolar fractures is widely debated. The aim of this study is to analyse the different treatment methods.

METHODS

The study included 137 patients with an isolated medial malleolar fracture treated at our hospital between 2000 and 2010. Functional outcome was assessed using Olerud-Molander score and health-related quality-of-life (HRQoL) was measured with RAND36 item health survey. Patients were sent follow-up questionnaires after an average of 9.5 years (4.3-15.2) from the date of treatment.

RESULTS

The overall improvement in function was equivalent in both operative and non-operative treatment groups. However, the outcome scores declined in both groups as the primary displacement increased, regardless of the treatment method. HRQoL was similar in both groups.

CONCLUSIONS

If maximal fracture displacement is ≤2mm, isolated medial malleolar fractures can be treated non-operatively with good outcome, but the operative treatment may also be performed without serious complications. The degree of fracture displacement is an independent risk factor for inferior functional result, regardless of the treatment method.

LEVEL OF EVIDENCE

Therapeutic level of evidence: IV, retrospective cohort study.