Ligament Ruptures in Ankle Fractures-Was Lauge-Hansen Right?

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Abstract

[Indexed for MEDLINE] 16. J Foot Ankle Surg. 2018 Nov-Dec;57(6):1096-1100. doi: 10.1053/j.jfas.2018.03.045. Epub 2018 Aug 23. Short-Term Outcomes and Influencing Factors After Ankle Fracture Surgery. Sung KH(1), Kwon SS(2), Yun YH(3), Park MS(4), Lee KM(5), Nam M(6), Jung JH(7), Lee SY(8). Author information: (1)Assistant Professor, Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea. (2)Assistant Professor, Department of Mathematics, College of Natural Science, Ajou University, Gyeonggi, Republic of Korea. (3)Professor, Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea. (4)Professor, Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea. (5)Associate Professor, Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea. (6)Orthopedist, Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea. (7)Orthopedist, Joeun Orthopaedic Clinic, Gyeonggi, Republic of Korea. (8)Clinical Associate Professor, Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea. Electronic address: kernels00@naver.com. The present study investigated the factors influencing the early clinical outcomes after ankle fracture surgery. We included 88 patients, who had undergone implant removal surgery at 1 year after ankle fracture surgery, with ankle computed tomographic (CT) scans obtained before ankle fracture surgery and at implant removal available. We collected demographic information, including age, sex, the presence of diabetes mellitus, level of trauma energy, and fracture classification from the medical records. We also recorded the fracture height using the radiographs and CT images. The medial joint space and articular incongruity were assessed on the follow-up radiographs and CT scans. Bone attenuation was measured by placing a circular region of interest around the ankle joint on the preoperative CT image. The postimplant removal outcomes were assessed using 2 functional questionnaires, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and Foot and Ankle Outcome Score (FAOS). Significant factors related to the AOFAS ankle-hindfoot scale scores and FAOS were identified through univariate analysis using age, sex, radiographic measurements, and CT findings as explanatory variables, followed by multiple regression analysis. On multiple regression analysis, the total FAOS was independently related to the AO classification (p = .003) and Lauge-Hansen classification (p = .003). The total AOFAS ankle-hindfoot scale score was related to articular incongruity (p = .044). The early clinical outcomes after ankle fracture surgery were affected by involvement of the ankle joint fracture rather than the lateral malleolus fracture height. Female sex and the presence of postoperative articular incongruity correlated with inferior early clinical outcomes. Copyright © 2018 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved. DOI: 10.1053/j.jfas.2018.03.045