Immediate Internal Fixation of Open Ankle Fractures

Abstract

Compared with closed ankle fractures, open ankle fractures have some unique injury features, and correspondingly require special treatment methods with respect to soft-tissue handling, restoration of large posterior malleolar fractures, the reconstruction sequence of malleolar fractures, and the management of distal tibiofibular syndesmotic diastasis.

Contemporary demographics and complications of patients treated for open ankle fractures

“…Additionally, it is known that in blast injuries to the foot and ankle a lower leg amputation may be required in up to one third of the injured patients [15]. In contrast to these previous studies [7,11,15], our results showed that many of the patients with an open ankle fracture are actually elderly women, who sustain an open ankle fracture resulting from low-energy injury mechanisms such as a same level fall. We also showed that there is a trend towards an increase in the incidence of open ankle fractures.…”

“…Previous studies have shown that open ankle fractures are usually high-energy injuries in young active patients [7,11]. Additionally, it is known that in blast injuries to the foot and ankle a lower leg amputation may be required in up to one third of the injured patients [15].…”

“…In view of the poor soft-tissue coverage around the ankle, the preservation of skin viability plays an important role in the successful treatment of open ankle fractures [11]. Wounds of open ankle fractures often result from skin that is lacerated by the displaced tibial plafond, such that most of the wound edge is viable and should not be resected [11].…”

“…In the limited literature on open ankle fractures, most studies have focused on high-energy injuries in young male patients [7,11,12]. Additionally, the main focus of these studies has been the timing of the internal fixation [7,11,13,14]. There is scant information about open ankle fractures in the elderly, and limited data regarding the complications and outcomes of these severe injuries in different age groups.…”

“…Furthermore, the rate of postoperative infections increases with higher Gustilo grades reflecting the more severe insult to softtissues [6][7][8][9][10]. In the limited literature on open ankle fractures, most studies have focused on high-energy injuries in young male patients [7,11,12]. Additionally, the main focus of these studies has been the timing of the internal fixation [7,11,13,14].…”