[Treatment results after primary management of severely dislocated ankle fractures with external fixation and subsequent internal osteosynthesis].
BACKGROUND
Between 1 January 2001 and 30 June 2003, 31 patients with dislocated ankle fractures were primarily treated with an external fixator in our clinic. The aim of the present study was to investigate whether such a concept would determine the overall outcome or influence single parameters such as mobility, dystrophy, pain, arthritis, and complications.


METHODS
Of the 31 patients, 25 aged 18-84 years at the time of the accident were followed up for 6-23 months to assess range of motion, clinical scores, radiological findings, and complications. An isolated injury was present in 23 patients and 3 were open injuries of second to third degree. Between two and five operations were necessary 4-27 days after trauma. The duration of primary hospital care required ranged from 10 to 43 days.


RESULTS
The Olerud and Molander score (9 criteria with 100 max points) was 80 points at the follow-up investigation (rated "good"). "Excellent" results (>90 points) were observed in four cases. In the range of motion there was only an average loss in plantar flexion of 12.4 degrees compared to the healthy side in the patients followed up.


CONCLUSIONS
The treatment result in the study population was compared to the results of prospective studies investigating dislocated ankle joint fractures as well as with our own random sample (n=7) of patients with secondarily treated ankle joint fractures that were initially treated with a cast. Initial external fixation seems to be justified and leads to acceptable results. The main functional lesions are not correlated to the specific treatment selected.
Bardenheuer
M
M
Klinik für Unfallchirurgie, Orthopädisch-unfallchirurgisches Zentrum, Universitätsklinikum Mannheim. mark.bardenheuer@klinikum-landshut.de
Philipp
T
T
Obertacke
U
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D016267:External Fixators / Q000706:statistics & numerical data*; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005593:Fracture Fixation, Internal / Q000379:methods / Q000706:statistics & numerical data; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods / Q000706:statistics & numerical data; D011859:Radiography; D012720:Severity of Illness Index; D016896:Treatment Outcome