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Arthroscopy for problems after ankle fracture

C N van Dijk1, R A Verhagen, J L Tol

  • 1Department of Orthopaedic Surgery, University of Amsterdam, The Netherlands.

The Journal of Bone and Joint Surgery. British Volume
|March 1, 1997
PubMed
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Ankle arthroscopy can relieve persistent pain after fractures, especially when anterior impingement is suspected. This surgical approach offers good to excellent results for many patients experiencing residual ankle discomfort.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Traumatology

Background:

  • Residual complaints after ankle fractures are common.
  • Anterior bony or soft-tissue impingement can cause persistent ankle pain.
  • Pre-existing osteophytes, linked to trauma and soccer, were noted in some patients.

Purpose of the Study:

  • To evaluate the efficacy of arthroscopic surgery for residual complaints following ankle fractures.
  • To compare outcomes between patients with clinically diagnosed anterior impingement and those with diffuse, unclear diagnoses.
  • To determine the benefit of arthroscopic surgery in managing anterior osteophytes and scar tissue.

Main Methods:

  • Prospective comparison of two groups (n=34) undergoing ankle arthroscopy for post-fracture complaints.

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  • Group I: clinically diagnosed anterior impingement (n=18).
  • Group II: diffuse, unclear diagnosis (n=16). Arthroscopic treatment involved removing anterior osteophytes/scar tissue.

    • Main Results:

    • Group I reported significantly higher patient satisfaction at two years (p=0.02).
    • Good or excellent outcomes were achieved in 76% of Group I patients versus 43% in Group II.
    • Arthroscopic removal of anterior osteophytes and scar tissue was the primary intervention.

    Conclusions:

    • Arthroscopic surgery can be beneficial for patients with residual ankle fracture complaints and clinical signs of anterior impingement.
    • The study suggests a limited role for purely diagnostic ankle arthroscopy.
    • Targeted arthroscopic intervention for anterior impingement yields superior patient outcomes.