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Categories: Abstracts, 2025-Nov, Poster

What is the Incidence of Symptomatic Late Post-Traumatic Ankle Arthritis Requiring Intervention following ankle fracture?

Samer Bitar, Milindu Makandura, Mona Theodoraki, James Davenport, Michael, Joseph Ring, Robert Smith, Timothy Clough

Wrightington

Introduction: To assess the 10-year outcomes of ankle fractures managed at our centre in 2014, specifically reviewing the incidence of symptomatic post-traumatic ankle arthritis requiring further intervention, including injections, fusion, or total ankle replacement (TAR).

Method: This retrospective cohort study included all 146 ankle fractures presenting between January and December 2014; pilon and talar fractures were excluded. Data was collated from electronic records and imaging, including fracture classification (Weber A/B/C), medial, posterior malleolar involvement, and syndesmotic fixation. Patient demographics, co-morbidities, initial management, and outcomes were recorded. Outcomes were assessed over 10 years, focusing on the need for further treatment of ankle arthritis.

Results: The cohort had a mean age of 48.8 years (range 6–89), with 50 male and 96 female patients. Smoking, diabetes, rheumatoid arthritis, and osteoporosis were present in 10.3%, 9.6%, 4.8%, and 8.2%, respectively. 21 patients died during follow-up; none required ankle intervention. Of the 146 fractures, 10 were Weber A, 76 Weber B, 49 Weber C, and 11 isolated medial malleolar. Surgical fixation was performed in 99 cases (67.8%). Medial malleolar fractures occurred in 82 cases (56.2%). Syndesmotic fixation was used in 23 cases (15.7%; 6 Tightrope, 17 screws). Posterior malleolar fractures were present in 37 cases (25.3%); 7 involving >1/3 of the articular surface treated with screw fixation and 30 <1/3rd articular surface – no posterior malleolar fixation. None received posterior plating. Over 10 years, one patient (Weber C) underwent ankle fusion at 2.4 years, and four patients (3 Weber B, 1 Weber C) received steroid injections at a mean of 3.9 years (2.5-6.3 years). No patients required TAR.

Conclusion: Very few ankle fractures (3.4%) progressed to clinically significant symptomatic arthritis requiring intervention over the next 10 years, with just 0.7% requiring surgery.

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Tags: Ankle Fracture Trauma

Documents to download

P7 -Bitar-Ankle fractures FINAL Samer Bitar.pdf(.pdf, 317.83 KB) - 6 download(s)

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