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Tibial plafond fractures. How do these ankles function over time?

J Lawrence Marsh1, Dennis P Weigel, Douglas R Dirschl

  • 1Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, College of Medicine, Iowa City 52242, USA. j-marsh@uiowa.edu

The Journal of Bone and Joint Surgery. American Volume
|February 7, 2003
PubMed
Summary

Tibial plafond fractures negatively impact ankle function and general health long-term, but most patients experience symptom improvement and require minimal additional surgery. This study evaluated outcomes five to twelve years post-injury.

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Rehabilitation Medicine

Background:

  • Limited data exists on the intermediate-term outcomes of tibial plafond fractures treated with current methods.
  • This study aimed to assess ankle function, pain, and general health status at least five years post-injury.
  • Identifying predictors of favorable and unfavorable outcomes was a key objective.

Observation:

  • Fifty-six tibial plafond fractures in fifty-two patients were treated using external fixation and screw fixation.
  • A subset of thirty-one patients (thirty-five ankles) underwent follow-up examinations five to twelve years post-injury.
  • Assessments included physical examination, Iowa Ankle Score, Ankle Osteoarthritis Scale, Short Form-36 (SF-36), and radiographs.

Findings:

  • Five of forty ankles required arthrodesis; only two patients had prominent screw removal.

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  • Long-term follow-up revealed negative impacts on general health, ankle pain, and function compared to controls.
  • Most patients reported limitations in recreational activities, particularly running, and some changed employment due to the injury.

    • Implications:

    • Tibial plafond fractures have a significant intermediate-term negative effect on ankle function and pain.
    • Despite functional deficits, few patients necessitate secondary reconstructive procedures.
    • Symptoms associated with these fractures demonstrate a tendency for long-term improvement post-healing.