The top-ranked cause of injury was high-energy injury (21.3%). Only one study was a prospective randomized trial. The detailed information was extracted for each article, such as researchers, age, gender, groups, type of study, type of center research, level of evidence, significant findings, study aim, cause of injury, time from injury to surgery, type of fracture, direction of dislocation, follow-up, postoperative complications and functional evaluation scores.Ī total of 15 studies (1,089 patients) met the inclusion criteria. The available literatures from January 1985 to December 2021 in three main medical databases were searched and analyzed. The purpose of this study was to review the previous literatures to understand the anatomy, mechanisms, treatment, and functional outcomes associated with ankle fracture-dislocations. Compared to the simple ankle fractures, ankle fracture-dislocations are usually more severely traumatized and can cause worse functional outcomes. Therapeutic III.Īnkle fracture-dislocations are one of the most severe types of ankle injuries.

This study showed no difference in TP and TF using the PROMIS outcome scores when comparing direct fixation versus indirect fixation under univariate and multivariate models. In the multivariate model, increased BMI, open injuries, and increasing tourniquet time all decreased TF while use of an external fixator increased TF. For TF, univariate analysis showed age, BMI, incidence of complication, and diabetes to decrease function, and use of external fixator and tourniquet time increased function. On multivariate analysis, BMI, incidence of complication, open injury, and tourniquet time all significantly increased pain. On univariate linear regression for TP, BMI, incidence of complication, tobacco use, and open injury showed significance in increasing pain levels with open injuries providing the greatest effect (coef = 11.8). There was no difference in TP or TF between groups (P = 0.65 vs. Univariate and multivariate linear regression models were performed to analyze factors that affect outcomes of TP and TF. Categorical variables were analyzed using a χ2 test. Continuous variables were analyzed using t tests for parametric variables and the Mann–Whitney U test for nonparametric variables. Primary outcomes were evaluated by PROMIS scores for short-term outcomes regarding total pain (TP) and total function (TF) comparing 40 patients with direct fixation with 77 with indirect fixation. The purpose of this study was to examine the differences in functional outcomes between direct and indirect surgical fixation methods of the posterior malleolus in the setting of trimalleolar fractures and identify any variables affecting patient outcomes.

Lauge hansen classification