Effectiveness comparison of open reduction and internal fixation for open and closed ankle Logsplitter fractures / 中国修复重建外科杂志

ABSTRACT

Objective: To investigate the effectiveness of open reduction and internal fixation on high-energy ankle Logsplitter injuries (a kind of transsyndesmotic ankle fracture dislocation), and compare the prognosis between open and closed Logsplitter fracture. Methods: The clinical data of 36 Logsplitter fractures treated with open reduction and internal fixation between April 2011 and May 2016 were retrospectively analyzed. Among them, 15 cases were open fracture and dislocation (open group) and 21 cases were closed fracture and dislocation (closed group). There was no significant difference between the two groups in gender, age, combined injury, injury to hospital admission time, and other general data ( P>0.05), with comparability. The wound healing, ankle mobility recovery, complications, and fracture healing were observed after operation. The ankle function was evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: Both groups were followed up 12-29 months (mean, 19 months). There was no significant difference in the follow-up time between the open group and the closed group ( t=1.169, P=0.251). In the open group, there were 3 cases of postoperative infection, 3 cases of nonunion, and 5 cases of post-traumatic osteoarthritis; the above complications occurred in 1 case in the closed group; there was no significant difference in complications between the two groups ( P=0.41) except post-traumatic osteoarthritis ( P=0.02). At last follow-up, there was no significant difference in AOFAS score between the two groups ( t=1.981, P=0.056). According to AOFAS score criterion, the results were good in 10 cases and general in 5 cases in the open group, and good in 13 cases and general in 8 cases in the closed group, showing no significant difference ( P=0.45). There was no significant difference in the fracture healing time and ankle flexion, dorsal extension, varus, and valgus motion between the two groups ( P>0.05). Conclusion: Open reduction and internal fixation for open or closed Logsplitter fractures can achieve satisfactory results, improve fracture healing rate, effectively reduce the incidence of complications, and improve ankle function.