Dislocation is a risk factor for poor outcome after supination external rotation type ankle fractures

Area of Science:

• Orthopedic surgery
• Traumatology
• Radiology

Background:

• Ankle fractures are common surgical cases.
• Ankle fracture-dislocations involve significant osseous and soft tissue injury.
• Limited research exists on the impact of dislocation on outcomes for SER IV ankle fractures.

Purpose of the Study:

• To evaluate the effect of dislocation on postoperative outcomes in SER IV ankle fracture patients.
• To compare radiographic and functional results between SER IV ankle fractures with and without dislocation.
• To inform patient counseling and surgical management strategies for ankle fracture-dislocations.

Main Methods:

• Prospective database of operative SER IV ankle fractures (2004-2010).
• Patients divided into dislocation and non-dislocation groups.
• Functional outcomes assessed using Foot and Ankle Outcome Score (FAOS) and range of motion (ROM) at minimum 1-year follow-up.

Main Results:

• 35% of 108 SER IV ankle fractures involved dislocation.
• Dislocation group had higher rates of open fractures and external fixator use.
• Dislocation group showed poorer articular reduction accuracy, increased pain, decreased daily living function (FAOS), and worse ankle/subtalar ROM.

Conclusions:

• Concurrent dislocation in SER IV ankle fractures is linked to worse radiographic and functional outcomes.
• Dislocation does not appear to increase the risk of superficial or deep infection.
• Findings aid in managing complex ankle injuries and counseling patients on expected outcomes.