Evaluation of Prognostic Factors in Surgically Treated Patients with Bi-malleolar Ankle Fractures

Document Type : Original Article (s)

Authors

1 Resident, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Various studies in the field of bimalleolar ankle fractures resulted in different findings. However, no reported study is available in Iran.Methods: The study population included 43 patients with bimalleolar ankle fractures who referred to hospitals associated with Isfahan University of Medical Sciences and underwent surgery during 2009. Foot and Ankle Outcome Score (FAOS) was used to collect data 6 months after the surgery. Mean scores were evaluated considering different factors such as age, sex, having diabetes, smoking and anatomic reduction.Findings: A significant difference was found in FAOS scores between men and women (P = 0.001) and between those with and without anatomic reduction (P < 0.001). However, the scores were not significantly different between smokers and non-smokers (P = 0.39). In addition, diabetic and non-diabetic patients were significantly different in terms of FAOS scores (P = 0.002). Conclusion: Factors such as sex, inappropriate reduction and having diabetes can affect the healing process and quality of life among patients with bimalleolar ankle fractures.

Keywords


  1. Cella DF. Measuring quality of life in palliative care. Semin Oncol 1995; 22(2 Suppl 3): 73-81.
  2. Aaronson NK. Quality of life: What is it? How should it be measuread? Oncology (huntingt) 1998; 2: 69–72
  3. Testa MA, Simonson DC. Assesment of quality-of-life outcomes. N Engl J Med 1996; 334(13): 835-40.
  4. McDowell I, Praught E. Survey measurements of emotional well-being: the health opinion survey and the Bradburn scale compared. Can J Public Health 1985; 76(4): 250-4.
  5. Keller RB. Outcomes Research in Orthopaedics. J Am Acad Orthop Surg 1993; 1(2): 122-9.
  6. Keller RB, Rudicel SA, Liang MH. Outcomes research in orthopaedics. Instructional Course Lectures 1994; 43: 599-611.
  7. Kannus P, Palvanen M, Niemi S, Parkkari J, Jarvinen M. Increasing number and incidence of low-trauma ankle fractures in elderly people: Finnish statistics during 1970-2000 and projections for the future. Bone 2002; 31(3): 430-3.
  8. Takao M, Ochi M, Naito K, Iwata A, Kawasaki K, Tobita M, et al. Arthroscopic diagnosis of tibiofibular syndesmosis disruption. Arthroscopy 2001; 17(8): 836-43.
  9. Marsh L . Ankle Fractures. In: Rockwood CA, Green DP, Bucholz RW, Heckman JD, Court-Brown CM, editors. Rockwood and Green's fractures in adults. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 2149-80.
  10. Davidovitch RI, Walsh M, Spitzer A, Egol KA. Functional outcome after operatively treated ankle fractures in the elderly. Foot Ankle Int 2009; 30(8): 728-33.
  11. Egol KA, Tejwani NC, Walsh MG, Capla EL, Koval KJ. Predictors of short-term functional outcome following ankle fracture surgery. J Bone Joint Surg Am 2006; 88(5): 974-9.
  12. Tejwani NC, McLaurin TM, Walsh M, Bhadsavle S, Koval KJ, Egol KA. Are outcomes of bimalleolar fractures poorer than those of lateral malleolar fractures with medial ligamentous injury? J Bone Joint Surg Am 2007; 89(7): 1438-41.
  13. Obremskey WT, Dart B, Medina M. Rate of return of functional outcome after open reduction and internal fixation of unstable ankle fractures. Am J Orthop (Belle Mead NJ) 2009; 38(5): 227-31.
  14. Lehtonen H, Jarvinen TL, Honkonen S, Nyman M, Vihtonen K, Jarvinen M. Use of a cast compared with a functional ankle brace after operative treatment of an ankle fracture. A prospective, randomized study. J Bone Joint Surg Am 2003; 85-A(2): 205-11.
  15. Finnan R, Funk L, Pinzur MS, Rabin S, Lomasney L, Jukenelis D. Health related quality of life in patients with supination-external rotation stage IV ankle fractures. Foot Ankle Int 2005; 26(12): 1038-41.
  16. Koval KJ, Zhou W, Sparks MJ, Cantu RV, Hecht P, Lurie J. Complications after ankle fracture in elderly patients. Foot Ankle Int 2007; 28(12): 1249-55.
  17. Bhandari M, Sprague S, Hanson B, Busse JW, Dawe DE, Moro JK, et al. Health-related quality of life following operative treatment of unstable ankle fractures: a prospective observational study. J Orthop Trauma 2004; 18(6): 338-45.