Total function, pain did not differ between direct, indirect fixation of ankle fractures
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CHICAGO — Results presented here showed no differences in patient-reported outcome measures in terms of total function and total pain among patients who underwent either direct or indirect surgical fixation of trimalleolar ankle fractures.
Luke G. Menken, DO, and colleagues compared total pain and total function through Patient-Reported Outcomes Measurement Information System scores between patients with trimalleolar ankle fractures who underwent open reduction and internal fixation with either direct surgical fixation of the posterior malleolus (n=40) or indirect surgical fixation of the posterior malleolus through reduction of the syndesmosis (n=77).
“Baseline demographics were compared between cohorts,” Menken said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “BMI was higher than average in the indirect cohort, and more patients had one or more types of comorbidities in the direct cohort. Otherwise, the variables were comparable between groups, especially for age and gender.”
Menken noted a greater proportion of patients in the indirect cohort received syndesmotic fixation, while a greater proportion of patients in the direct cohort had a posterolateral approach utilized during surgery. He added the two groups had no significant differences in total pain scores or total function scores.
“Significant factors that all increased total pain in our patients were higher BMI, presence of an open fracture, presence of a complication and increased tourniquet time,” Menken said.
Menken also noted these same factors decreased total function, while the use of an external fixation in a staged surgical plan increased total function.
“There was a 15% complication rate in the direct cohort and a 22% complication [rate] in the indirect cohort,” Menken said. “We did not find these to be statistically significant.”
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Saad B, et al. Paper 568. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 22-26, 2022; Chicago.
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