ABSTRACT
Soft tissue injuries associated with malleolar fracture−dislocations may increase
postoperative rates of wound complication. Ankle-spanning frame plays a fundamental
role in the local damage control orthopedics while gaining time for definitive surgery.
The objective of this study was to evaluate the effect of a 2-stage surgery for the
unstable malleolar fracture−dislocations with severe soft tissue injuries compared
to a 1-stage surgery in terms of the American Orthopaedic Foot and Ankle Society (AOFAS)
hindfoot−ankle and Olerud-Molander ankle scores (OMAS). We analyzed 45 patients who
met our study criteria. The patients were divided into 2 groups according to staged
surgeries. Demographic data of patients, comorbidities, alcohol and tobacco use, Tscherne
soft tissue injury scores, the AOFAS hindfoot−ankle and OMAS, postoperative complications,
total hospitalization times, waiting time between stages, and waiting time from admission
to surgery times were investigated. There was a statistically significant difference
between the groups in terms of the mean total hospitalization times (p = .007), waiting time from admission to surgery (p < .001), gender (p = .005), and Tscherne soft tissue injury scores (p < .001). The mean AOFAS hindfoot−ankle and OMAS of the groups did not differ statistically
at a minimum of 12 months of the follow-up period (p = .094 and p = .126, respectively). A 2-stage surgery can be performed safely in the carefully
selected patients with the unstable malleolar fracture−dislocations with Tscherne
grades 2 and 3 soft tissue injuries, and this surgery does not affect the postoperative
AOFAS hindfoot−ankle and OMAS statistically compared to a 1-stage surgery at a minimum
of 12 months of the follow-up period.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: May 10, 2019
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
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© 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.
