The Analysis Of Affect Factors Of The Clinical Outcome With Old Ankle Fracture And Dislocation

Objective: to study the affect factors of the clinical outcome of old ankle fracturesand dislocation and guide the clinical treatment.Methods:52cases of old ankle fractures and dislocation in our hospital betweenAugust2003and July2012were analyzed, all52cases could reach for finalfollow-up. All of them were bimalleolar or trimalleolar fractures.47cases acceptedORIF,5cases accepted conservative treatment. The American Orthopaedic Foot andAnkle Society(AOFAS)rating system was used to evaluate the function of the anklepostoperatively（1year post-operation）. All cases were divided into two groupsaccording to whether they have medial malleolar fractures or not, posterior malleolarfractures and the integrity of distal tibiofibular syndesmosis were also considered asaffect factors. According to the AOFAS, All cases were divided into two groups:Group I：AOFAS≥80，Group II：AOFAS＜80， four fractors were analyzed:posterior malleolar fractures、medial malleolar fractures、time to revision(the intervaltime between the initial injury and the revision surgery), integrity of distal tibiofibularsyndesmosis, in order to find out whether they have any influence on the final results.Results: the mean follow-up time was35.6months (range13-60months). Allcases reported benefit from the revision procedure.4cases of skin flay necrosisrecovered well after proper treatment. There was a significant difference (Pvalue<0.05) with the condition that whether the patients associated with posterior malleolarfractures or not. And the interval time between the initial injury and the revisionsurgery also influence the final results. But there was no significant differencewhether the patients had medial malleolar fractures or not. Distal tibiofibularsyndesmosis injury also has no influence on the final results.Conclusion:1.posterior malleolar fractures, time to revision will affect clinicaloutcome.2.Medial malleolar fractures and distal tibiofibular syndesmosis injury has no influence on the final results.