Ankle fractures: emergency department management...is there room for improvement?
OBJECTIVE
The aim of this study was to identify pitfalls in the acute management of ankle fractures which were referred to a regional orthopaedic unit. This unit provides orthopaedic services for the catchment area of the Waterford Emergency Department together with three additional emergency units in the south-eastern region of Ireland.


METHODS
This is a retrospective study of all patients referred to the Waterford Regional Orthopaedic service from 1 January 2001 to 31 December 2001 for management of acute ankle fractures.


RESULTS
A total of 236 patients were identified during the study period. Open reduction and internal fixation were performed in 200 cases. In all, 52% of patients had definitive surgery within 24 h of their injury. These patients were evenly distributed between regional (64%) and peripheral (60%) emergency unit referrals. 24% of patients required essential manipulation prior to surgery. This had been performed in only 34% of cases prior to transfer. Two patients were transferred with a pulseless foot.


CONCLUSIONS
Ankle fractures are a common musculoskeletal injury seen in emergency departments and minor injury units. Long-term disability resulting from ankle fractures can be reduced by optimal early management procedures. This is an important area for consideration in education programmes in emergency medicine.
Deasy
Conor
C
Department of Orthopaedics, Waterford Regional Hospital, Ireland. conordeasy@hotmail.com
Murphy
Diarmuid
D
McMahon
Geraldine C
GC
Kelly
Ian P
IP
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D012017:Referral and Consultation; D012189:Retrospective Studies; D013997:Time Factors