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Related Concept Videos

Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Functional outcomes after ankle fracture-dislocation: a systematic review.

Helena F Barber1, Zachary D Randall2, Matthew J Strok3

  • 1Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA. barberh@wustl.edu.

Archives of Orthopaedic and Trauma Surgery
|January 11, 2025
PubMed
Summary
This summary is machine-generated.

Ankle fracture-dislocations, especially Logsplitter injuries, result in poorer functional outcomes compared to typical ankle fractures. These high-energy injuries affect younger patients and require further study for employment impact.

Keywords:
Ankle fractureAnkle fracture-dislocationComplicationsFunctional outcomesLogsplitter

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Area of Science:

  • Orthopedic Surgery
  • Trauma Care
  • Biomechanics

Background:

  • Ankle fractures are common orthopedic injuries, with fracture-dislocations often leading to worse patient outcomes.
  • Logsplitter fractures, a specific type of ankle fracture-dislocation, involve the talus wedged in the tibiofibular joint.

Purpose of the Study:

  • To comprehensively investigate and report on the complications and functional outcomes associated with ankle fracture-dislocations.
  • To compare functional outcomes between Logsplitter injuries and other ankle fracture-dislocations.

Main Methods:

  • A systematic literature review following PRISMA guidelines was conducted across multiple databases.
  • Included studies reported functional or employment outcomes for ankle fracture-dislocations.
  • Excluded were non-English studies, reviews, and case reports with fewer than five patients.

Main Results:

  • Twenty-one studies involving 810 cases of ankle fracture-dislocations were analyzed.
  • The pooled mean American Orthopaedic Foot & Ankle Society (AOFAS) score was 81.5, indicating good outcomes.
  • Logsplitter injuries showed significantly lower AOFAS scores (75.8) compared to other ankle fracture-dislocations (82.9).
  • Common complications included wound infection (7.3%), posttraumatic osteoarthritis (29.2%), and nonunion/malunion (12.6%).

Conclusions:

  • Ankle fracture-dislocations are high-energy injuries affecting a younger demographic, with functional outcomes similar to pilon fractures.
  • Logsplitter injuries, occurring in even younger patients, are associated with worse functional outcomes.
  • Further research is needed to assess the impact on return to employment.