Effectiveness of ankle arthroscopic debridement in acute, subacute ankle- bimalleolar, and trimalleolar fractures

Int Orthop. 2021 Mar;45(3):721-729. doi: 10.1007/s00264-020-04882-6. Epub 2021 Jan 8.

Abstract

Background: The purpose of this retrospective study was to evaluate the usefulness of ankle arthroscopy at the time of ORIF or after six months in patients with residual symptoms. The hypothesis was that in patients treated arthroscopically at the time of ORIF, there were faster and better clinical results than those treated after or untreated with arthroscopy.

Methods: In this retrospective study, we compared three homogeneous groups of selected patients with specific inclusion criteria (144 in total, mean age 38.2 years). They have been surgically treated for an ankle fracture (bimalleolar or trimalleolar without frank syndesmotic injuries) with open technique (ORIF) or arthroscopic ORIF (AORIF), between 2013 and 2017. The AO classification system was used for each patient. The clinical assessment was based on the Foot and Ankle Outcome Score (FAOS).

Results: At the final follow-up (mean 38 months), both patients treated with ankle arthroscopic debridement at the time of ORIF and patients treated with arthroscopic debridement after ORIF showed a significant improvement of the FAOS, which reported 84 and 85 respectively at final follow-up.

Conclusion: Through minimally invasive visualization of intra-articular structures, ankle arthroscopy can offer an essential option for selected patients both in acute and in sequelae after an ankle fracture. More studies are needed to understand the real effectiveness of the procedure, especially in acute at the same time of osteosynthesis.

Keywords: Ankle arthroscopy; Ankle fractures; FAOS score.

MeSH terms

  • Adult
  • Ankle
  • Ankle Fractures* / surgery
  • Ankle Joint / surgery
  • Arthroscopy
  • Debridement
  • Fracture Fixation, Internal / adverse effects
  • Humans
  • Retrospective Studies
  • Treatment Outcome