Immediate internal fixation of open ankle fractures
Wang Hong-Chuan1, Kan Shi-Lian, Shu Heng-Sheng
1Department of Orthopaedic Traumatology, Tianjin Orthopedics Hospital, Tianjin 300211, China. hongchuanwang@hotmail.com
Foot & Ankle International
|December 30, 2010
Summary
Open ankle fractures present unique injury patterns requiring specialized surgical techniques. This study details these features and operative methods, achieving good outcomes with effective wound management and fixation.
Area of Science:
- Orthopedic Surgery
- Trauma Management
- Fracture Healing
Background:
- Open ankle fractures are common injuries.
- Immediate internal fixation is often successful with low infection rates.
- Distinctive injury features and treatment nuances of open ankle fractures are underreported.
Purpose of the Study:
- To investigate the unique injury characteristics of open ankle fractures.
- To analyze the operative techniques employed for these fractures.
- To exclude pilon fractures from the analysis.
Main Methods:
- Retrospective analysis of 96 patients with open ankle fractures (2001-2008).
- 92 patients were followed for an average of 35 months.
- Standardized treatment protocol: early antibiotics, irrigation, debridement, and fixation based on fracture classification and wound condition.
Main Results:
- Primary wound healing in 65 patients; superficial necrosis in 19.
- Low rates of delayed healing (4) and superficial infection (2); one deep infection in a diabetic patient.
- Average fracture healing time of 13 weeks; mean AOFAS score of 90.4.
Conclusions:
- Open ankle fractures possess distinct injury features compared to closed fractures.
- Specialized treatment is necessary for soft-tissue management, posterior malleolar fracture repair, fracture reconstruction sequence, and syndesmotic diastasis.
- The findings guide tailored surgical approaches for optimal outcomes in open ankle fractures.
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