Abstract
The influence of perioperative soft tissue complications on the functional outcome after open reduction and internal fixation of closed ankle fractures was investigated. Eighty-eight consecutive patients were followed 3.7 years (SD ± 0.6) after the injury. Two major and 21 minor soft tissue complications were registered. Average dorsal extension was 29.9° (range four to 54, SD ± 9.5) of the fractured ankles and 37.2° (range eight to 60, SD ± 9.1) of the non-fractured ankles. The average subjective functional score was 84.6 (range 40 to 100, SD±14.9). A significant difference was found with respect to the subjective functional score (p = 0.048, Kruskal-Wallis test) but not with respect to dorsal extension (0.358, Kruskal-Wallis test) when comparing groups of minor, major and no soft tissue complications. This study suggests that major soft tissue complications have a negative effect on the long-term functional outcome after surgical repair of an ankle fracture. Minor soft tissue complications, primary skin problems, the timing of primary surgery and fracture types according to AO/ASIF have no or minor influence on the long-term functional result. This study confirms previous reports that the presence of osteoarthritis is frequently associated with a reduced functional outcome.
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