Unstable ankle fractures: comparison of closed versus open treatment

To determine what factors were important in final clinical results, we evaluated 145 patients admitted to Vanderbilt University Hospital with ankle fractures between January 1971 and December 1976. There was a strong correlation between anatomic results of reduction and final clinical results. Talar displacement of more than 5 mm before reduction, a posterior malleolus fracture involving more than 25% of the articular surface, an anterior tibial plafond fracture involving more than 25% of the articular surface, and talus fractures involving the articular surface were four variables which significantly affected results. Open reduction, torn deltoid ligaments, open fractures, type of fracture, type of internal fixation devices used, sex, and age did not signficantly affect results. Other injuries in association with ankle fractures, especially after automobile accidents, frequently prolonged hospitalization.