title: [Treatment of acute ankle fractures with arthroscopy-assisted open reduction and internal fixation].
abstract: OBJECTIVE
  To explore the clinical results of arthroscopy-assisted open reduction and internal fixation for the treatment of acute Lauge-Hansen stage IV ankle fractures.
  
  
  METHODS
  A prospective cohort of study was done in 42 patients of acute ankle fractures treated with arthroscopy-assisted open reduction and internal fixation from January 2008 to December 2009. According to Lauge-Hansen classification, there were 26 supination-eversion stage IV fractures, including 11 females and 15 males; with an average age of (36.8 +/- 11.7) years; and there were 16 pronation-eversion stage IV fractures, including 6 females and 10 males, with an average age of (37.6 +/- 11.2) years. All the patients were treated with arthroscopy-assisted open reduction and internal fixation,and intra-articular disorders were observed. Syndesmotic diastasis was treated with three-cortices syndesmotic screw, and osteochondral injuries were disposed by Cheng-Ferkel staging system. The clinical effects were evaluated according to AOFAS scores.
  
  
  RESULTS
  All the patients were followed up for 1 year. At the final review,the mean AOFAS score was (92.00 +/- 9.32). Twenty-eight patients got an excellent result, 11 good, 3 fair. Lesions of the cartilage were found in 31 cases. The AOFAS scores of patients with osteochondral lesions were higher than those of patients without osteochondral lesions. The AOFAS scores of patients with osteochondral lesions below C grade were higher than those of patients with osteochondral lesions above C grade. The AOFAS scores of patients with osteochondral lesions were higher than those of patients with osteochondral lesions above C grade. The AOFAS scores of patients with syndesmosis fixation were lower than those of patients without syndesmosis fixation.
  
  
  CONCLUSIONS
  Intra-articular disorders are common in Lauge-Hansen stage IV ankle fractures, and osteochondral lesion and sydesmosis diastasis are the most important prognostic factor that leads to unsatisfactory ankle functions. Arthroscopy-assisted open reduction and internal fixation for the treatment of acute ankle fractures is not only helpful to anatomical reduction of the articular surface, but also can improve the clinical results with effective diagnosis and treatment of combined intra-articular disorders.
authors: Department of Orthopaedics, Tongde Hospital, Hangzhou 310000, Zhejiang, China. jiayuan_402@163.com
authors: Rui-jian
authors: RJ
authors: Yan
authors: Xiao-wen
authors: XW
authors: Zhang
authors: Gou-ping
authors: GP
authors: Ma
authors: Qiao-feng
authors: QF
authors: Guo
authors: Chun
authors: C
authors: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult