[Late infections after open reduction and internal fixation of the upper ankle joint]

A 63-year-old patient suffering from diabetes mellitus and arterial occlusive disease sustained a displaced fracture of the upper ankle joint. The fracture was treated by open reduction and internal fixation (ORIF) but 6 months later a delayed infection developed. Partial implant removal and a single lavage were performed. With persistent signs of infection full implant removal and subsequently debridement and lavage were carried out 3.5 months later followed by arthrodesis of the upper ankle joint. The arbitration board decided that the treatment applied after diagnosing the delayed infection was not sufficient which led to a delay in appropriate treatment. However, whether the arthrodesis of the upper ankle joint could have been prevented could not be proven.