Short-term Outcomes and Quality of Life Following Surgical Treatment of Bimalleolar Ankle Fractures

Bimalleolar ankle fractures, particularly those resulting from supination-external rotation (SER) mechanisms, are common injuries. This study evaluates the short-term clinical outcomes and quality of life following surgical treatment of these fractures.

This prospective cohort study was conducted at two trauma centers in Isfahan, Iran. A total of 34 adults, with SER-type bimalleolar ankle fractures, underwent open reduction and internal fixation. Additionally, a matched control group comprising 34 healthy individuals was included in the study. Functional outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS) and the Short Form-36 (SF-36) in the control group, as well as at three and six months post-surgery for the patient group.

The study included 24 males (70.6%) and 10 females (29.4%) in the case group, with a mean age of 32.8 years (SD ± 9.7) and a mean BMI of 26.01 kg/m² (SD ± 1.91). Significant improvements were observed in the patient group from three to six months post-surgery across multiple FAOS and SF-36 domains. FAOS pain scores increased from 67.8 ± 7.5 to 83.9 ± 8.3 (P < 0.001), and activities of daily living improved from 75.3 ± 8.0 to 88.7 ± 8.5 (P < 0.001), approaching control levels. SF-36 physical functioning scores rose from 63.5 ± 8.2 to 81.3 ± 7.9 (P < 0.001). However, domains, like symptoms, sports/recreation, social functioning, and role-emotional, remained lower than controls at six months (P > 0.05).

Surgical treatment of bimalleolar ankle fractures leads to significant short-term functional improvements, with a low complication rate. While promising, continued rehabilitation beyond six months may be necessary for complete functional restoration.