Basic Characteristics, Comorbidity, and Patient-Reported Outcome Following Surgically Treated Patients With Ankle Fractures: An Observational Study With Mean 5.1 Years Follow-up

Background: Information is lacking regarding the association between basic characteristics and outcome following surgically treated ankle fractures. This study aims to investigate basic characteristics and comorbidity of surgically treated ankle fracture patients and their influence on long-term Foot and Ankle Outcome Score (FAOS) subscale scores. The secondary aim was to compare long-term FAOS subscale scores to national FAOS reference values. Methods: The study design was a retrospective cohort study. Adult patients with a surgically treated ankle fracture between January 1, 2017, and December 31, 2018, were included. Basic characteristics such as age, gender, comorbidity, and fracture classification were obtained. Patient-reported outcome was derived using the FAOS in March 2023. Results: Included were 278 patients available for analysis of basic characteristics and comorbidity. The mean age was 54.2 years (range = 18-96), and 59% were female. A total of 202 patients (73%) had a Charlson Comorbidity Index (CCI) of 0 and the mean CCI was 0.72 (95% confidence interval [CI] = 0.54-0.90). Cardiovascular disease (17.6%) was the most frequent comorbidity, followed by diabetes (6.4%). A total of 122 of 242 patients (50%) completed the FAOS questionnaire. Age and gender were observed with non-significant associations to FAOS subscale scores. Body mass index (BMI) was observed with significant signification for the subscale activities of daily living (ADL), Sport/Rec, and quality of life (QOL) (P < .04). No significant difference between patients with and without comorbidity was observed in FAOS subscale scores, due to non-overlapping 95% CIs. Conclusion: This 2-year consecutive sample of surgically treated ankle fractures revealed a low degree of comorbidity with more than 73% of patients observed with a CCI of 0. In contrast to BMI, baseline characteristics such as age and gender showed no significant association to the long-term FAOS. The FAOS subscale scores showed worse outcomes compared to representative reference values, indicating considerable patient-perceived complaints even years after fracture. Further research is needed to investigate the influence of comorbidity and fracture subgroups on long-term patient-reported outcome.