Background: Despite considerable improvements in surgical treatment strategies for unstable ankle fractures, long-term follow-up studies on conventional treatment strategies are missing. The aim of the study was to assess the patient-reported long-term outcome (≥15 years) following surgically treated ankle fractures. Methods: Retrospective, single-center, outcome study with a current follow-up. Identified were all patients treated surgically for an unstable ankle fracture between January 2003 and October 2009. Treatment was performed according to the AO principles. General demographics, injury-, fracture- and treatment details, as well as the current patient-reported outcome (Olerud-Molander Ankle Score OMAS, the Foot and Ankle Ability Measure FAAM, the European Foot 54% female, 48% left side) were included. The average age at trauma was 43.1 ± 11.8 years, and the mean follow-up 17.8 ± 2.0 years. Overall, 43%, 22%, and 34% sustained a unimalleolar, bimalleolar, and trimalleolar fracture, respectively. In addition, 53% had a fracture to the posterior malleolus. The overall median outcome for the OMAS, FAAM daily, and EFAS daily were 100 (interquartile range IQR 15), 99 (IQR 7), and 96 (IQR 16), respectively. The EQ-5D-5L scored at a median of 1.00 (IQR 0.09). The number of malleoli fractured was the only factor affecting all outcome scores. A moderate or poor outcome was reported for 5% of unimalleolar, 18% of bimalleolar, and 30% of trimalleolar fractures. Conclusion: Although the overall functional outcome was good, about 15% of patients had considerable impairment. The only factor associated with the patient-reported outcomes was the number of malleoli fractured, with 30% of patients with a trimalleolar ankle fracture presenting inferior outcomes.
Scheuer et al. (Mon,) studied this question.
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