[Predictive value of different injured components in ankle fractures]

Injuries of the medial ankle side or the posterior tibial margin do not necessarily predict a negative outcome in ankle fractures, as shown in this comprehensive retrospective study on 342 consecutive patients. A negative predictive value results from the combination of different injured ankle components. Clinical and radiological results correlate well with each other and with the severity of the fracture. They deteriorate according to the number of injured ankle components. Thickening of the soft tissues most often results from complex injuries. It leads to a decrease in range of motion and therefore determines the clinical outcome. Eighty-nine percent of the patients with a personal follow-up and 94 % of those with a written investigation had good to very good results, which represent the upper range of other presentations. This can be achieved by a subtle surgical technique with exact anatomic reduction including primary treatment of at least the severe injuries within the first few hours after trauma. Complications occurred in 9 % of cases, which coincides with the findings of other authors. Especially elderly and obese patients are at higher risk.