title: Arthroscopic Assessment of Intra-Articular Lesion after Surgery for Rotational Ankle Fracture.
abstract: BACKGROUND
  The purpose of this study was to report findings of exploratory arthroscopic assessment performed in conjunction with removal of internal fixation device placed in the initial surgery for rotational ankle fracture.
  
  
  METHODS
  A total of 53 patients (33 male, 20 female) who underwent surgery for rotational ankle fracture between November 2002 and February 2008 were retrospectively reviewed. All patients gave consent to the exploratory arthroscopic surgery for the removal of internal fixation devices placed in the initial surgery. Lauge-Hansen classification system of ankle fractures was assessed for all patients. Intra-articular lesions (osteochondral lesion, loose body, and fibrosis) were evaluated via ankle arthroscopy. Comparative analysis was then performed between radiological classification of ankle fracture/patient's symptoms and arthroscopic findings.
  
  
  RESULTS
  Lauge-Hansen classification system of ankle fractures included supination-external rotation type (n = 35), pronation-external rotation type (n = 9), and pronation-abduction type (n = 9). A total of 33 patients exhibited symptoms of pain or discomfort while walking whereas 20 exhibited no symptoms. Arthroscopic findings included abnormal findings around the syndesmosis area (n = 35), intra-articular fibrosis (n = 51), osteochondral lesions of the talus (n = 33), loose bodies (n = 6), synovitis (n = 13), and anterior bony impingement syndrome (n = 3). Intra-articular fibrosis was seen in 31 of symptomatic patients (93.9%). Pain or discomfort with activity caused by soft tissue impingement with meniscus-like intra-articular fibrosis were found in 19 patients. There was statistical significance (p = 0.02) between symptoms (pain and discomfort) and the findings of meniscus-like fibrosis compared to the group without any symptom.
  
  
  CONCLUSIONS
  Arthroscopic examination combined with treatment of intra-articular fibrosis arising from ankle fracture surgery may help improve surgical outcomes.
authors.affiliation: Department of Orthopedic Surgery, Saeum Hospital, Seoul, Korea.
authors.forename: Seung-Do
authors.initials: SD
authors.lastname: Cha
authors.affiliation: Department of Orthopedic Surgery, Maryknoll Hospital, Busan, Korea.
authors.forename: Jae-Yong
authors.initials: JY
authors.lastname: Kwak
authors.affiliation: Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors.forename: Heui-Chul
authors.initials: HC
authors.lastname: Gwak
authors.affiliation: Department of Orthopedic Surgery, Maryknoll Hospital, Busan, Korea.
authors.forename: Dong-Jun
authors.initials: DJ
authors.lastname: Ha
authors.affiliation: Department of Orthopedic Surgery, Maryknoll Hospital, Busan, Korea.
authors.forename: Jong-Yup
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Maryknoll Hospital, Busan, Korea.
authors.forename: Ui-Cheol
authors.initials: UC
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Maryknoll Hospital, Busan, Korea.
authors.forename: Yue-Chan
authors.initials: YC
authors.lastname: Jang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D064386:Ankle Fractures / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D018771:Arthralgia; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005355:Fibrosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Ankle fracture; Arthroscopy; Fibrosis