Abstract
The complex nature of ankle fractures is magnified when seen in patients at high risk
of soft tissue wound healing complications. The major categories include associated
soft tissue injury, diabetes, tobacco use, peripheral vascular disease, malnutrition,
alcoholism, and corticosteroid use. Because of the potential for wound dehiscence
and infection with open reduction and internal fixation of ankle fractures in these
patients, minimally invasive procedures have been described. The aims of the present
study were to assess the possibility for, and evaluate the results and complications
of, minimally invasive techniques for different types of malleolar fractures in high-risk
patients. We report the clinical results of 47 high-risk patients who presented with
malleolar fractures from January 2007 to December 2012 and underwent minimally invasive
reduction and fixation. One patient (0.5%) developed a superficial infection; however,
none of the patients displayed wound dehiscence or deep infection. Five patients (10.6%)
required open reduction because of intraoperative failure to achieve anatomic reduction.
Using the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale, 15 of
the patients (36%) treated with minimally invasive techniques experienced an excellent
outcome. In contrast, 23 patients (55%) had a good, 3 (7%) a fair, and 1 (2.5%) a
poor outcome. The results of our study have shown that minimally invasive fixation
appears to be a satisfactory method for the management of malleolar fractures in high-risk
patients and could be helpful in the avoidance of the complications associated with
conventional open reduction and internal fixation.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
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© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
