Posttraumatic ankle osteoarthritis after ankle-related fractures.
OBJECTIVE
The present study analyzes etiologies, pathomechanisms, and predisposing factors that lead to the development and progression of posttraumatic ankle osteoarthritis (OA) after ankle-related fractures.


METHODS
Retrospective cohort study.


METHODS
Tertiary health care center.


METHODS
The underlying cohort was 257 painful end-stage ankle OA patients (270 cases) presenting to the authors' clinic. Patients from this cohort with a history of ankle-related fracture (141 patients) were evaluated.


METHODS
Analysis of individual clinical and radiologic history since the time of injury; physical and radiologic examination at the time of ankle OA.


METHODS
OA latency time, fracture type, treatment methods, complication of fracture healing, soft tissue situation, age, pain score, American Orthopedic Foot and Ankle Society ankle score, range of motion, radiologic tibiotalar alignment, and radiologic ankle OA grading were evaluated.


RESULTS
The latency time between injury and end-stage ankle OA was 20.9 years (1-52 years). Malleolar fracture was the most common fracture (53.2%). A negative correlation of the OA latency time with the fracture severity was observed for some fracture types (pilon fractures, r = -0.4, P < 0.01). Patients with complications during the healing process showed significantly shorter OA latency time (P < 0.01). The patients' age at time of injury correlated negatively with the OA latency time (r = -0.6, P < 0.01).


CONCLUSIONS
The present study addresses the link between ankle-related fractures and secondary posttraumatic ankle OA. The latency time between injury and OA depends on fracture type and severity, occurrence of complications in the healing process, and patient-related factors, for example, age.
Horisberger
Monika
M
Orthopaedic Department, University Hospital of Basel, University of Basel, Basel, Switzerland. monika.horisberger@hotmail.com
Valderrabano
Victor
V
Hintermann
Beat
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D017102:Fracture Healing; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D011859:Radiography; D012189:Retrospective Studies; D013557:Switzerland / Q000453:epidemiology; D013978:Tibial Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D015599:Trauma Severity Indices; D055815:Young Adult