Clinical, functional and radiological outcome after osteosynthesis of ankle fractures using a specific provocation test

Abstract

Abstract Background Ankle fractures are frequent and despite numerous publications on its treatment and outcome, there is a lack of precise data on the functional results in young, healthy and sportive patients. We hypothesized that patients after open reduction and internal fixation (ORIF) of a simple ankle fracture would have a similar function compared to a healthy control group, whereas patients with complex fractures will have significant functional deficits. Furthermore, we postulate that there is a discrepancy between the radiological and the functional outcomes. Methods Therefore, a specific provocation test has been developed to evaluate the postoperative possibilities of weight bearing, stop-and-go activities and range of motion during extremes of movements. In combination with three questionnaires and a radiographic evaluation the true functional outcome and the possibility of participating in sportive activities has been investigated and compared with an age and sex matched control group. Results A clear impairment even in unilateral and simple ankle fractures has been found. Impairment increased in tests including stop-and-go activities in combination with load bearing and with the complexity of the fractures. Concerning the subjective outcome there was a significant impairment in daily activities without any difference in preoperative and postoperative sportive activity between the groups. No difference was found in the radiological assessment. Conclusions The study shows the need of more complex functional evaluation in young and sportive patients after open reduction and internal fixation of an ankle fracture. Trial registration: BASEC-Nr. 2018 − 01124