Delayed treatment of ankle fracture.

BACKGROUND

Cases of old ankle fractures with different delayed treatments in different conditions were collected and evaluated to determine which treatments were optimal for individual type of fractures.

METHODS

Sixteen cases of old ankle fractures were managed by open reduction and internal fixation, osteotomy, or removal of loose fragment according to the condition of the fractures between 1977 and 1987. The follow-up period was from 5 to 15 years with mean 7.9 years. The final result was evaluated by a modified performance index.

RESULTS

All the 12 patients treated with open reduction and internal fixation for malposition got improved with the mean performance score rising from 37 before operation to 76 after operation. Improvement was also noted in all the 3 patients treated with osteotomy for malunion without significant arthritis, rising from 44 to 88. One patient had painful non-united fragment of medial malleolus, and removal of the loose fragment was done to improve the score from 58 to 96.

CONCLUSIONS

Management of old ankle fractures can be effective and beneficial when appropriate treatments are given according to the different conditions of the fracture and joint.