Abstract
Category:
Ankle, Ankle Arthritis, Arthroscopy
Introduction/Purpose:
The role of ankle arthroscopy in managing the consequences of ankle fractures is yet to be fully estab- lished. This study aims to assess this procedure in terms of the accuracy of preoperative diagnosis, re-operation rate and patient- reported outcomes.
Methods:
We compared two homogeneous groups of 16 patients (32 in total, average age 40.6 years) operated for a fracture of the distal tibia and/or fibula treated with ORIF.
For all fractures the AO classification was used. The baseline was 6 months after surgery.
Inclusion criteria were: patients aged between 19 and 50 a pre-trauma Tegner score >3, FAOS score <75 at the baseline, R.O.M. <20° vs contralateral; we included patients with well-aligned osteosynthesis and with radiographic union.
Patients with open fractures, with osteochondral lesions and with previous were excluded. In the first group we planned an arthroscopy of the ankle from 6 to 12 months after trauma, in the second group, we continued with conservative rehabilitation treatment.
All patients were then re-evaluated at 3,6 and 12 months with questionnaires (Tegner activity level, and FAOS).
The mean follow-up was 18.2 months.
For all data statistical analysis was performed.
Results:
The results of our case-series showed excellent patient satisfaction (12/14) with a FAOS Score and an improved R.O.M. statistically significant (p <.001) in patients treated with ankle arthroscopy. Eighty percent was able to return to previous activity. The average time until return to sport was 5.3 ± 2.4 months. Seventy percent of the athletes still had occasional pain with sport.
Conclusion:
The literature on arthroscopic treatment after fracture is still poor but results obtained, even with a limited number of cases, and with a short follow-up, are positive, especially in those patients where the functional demand is highest.