Ankle Arthroscopy: A Complimentary Adjunct in the Diagnosis and Management of Ankle Fractures

作     者：Ciaran McDonald Conor O’Dwyer Peter McLoughlin Rebecca Jeanne Bermingham Thomas Bayer Ciaran McDonald;Conor O’Dwyer;Peter McLoughlin;Rebecca Jeanne Bermingham;Thomas Bayer

作者机构：Department of Orthopaedics and Trauma Midlands Regional Hospital Tullamore Tullamore Ireland 

出 版 物：《Open Journal of Orthopedics》 (矫形学期刊（英文）)

年 卷 期：2020年第10卷第12期

页      面：403-411页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Ankle Fracture Arthroscopy Osteochondral Injury Syndesmosis Lauge-Hansen ORIF Ligamentous Injury Syndesmosis Disruption Persistent Ankle Pain Post-Traumatic Arthritis 

摘      要：Ankle fractures are one of the most common injuries treated by orthopaedic surgeons. A minority of patients with ankle fractures go on to develop persistent pain following anatomical reduction. These sequelae may arise as a result of untreated ligamentous or chondral injuries. This study aims to correlate acute arthroscopic ankle findings with the Lauge-Hansen fracture pattern classification. We further aim to compare subjective functional outcomes at least one year following surgery between patients who have received Open Reduction and Internal Fixation (ORIF) alone, versusORIF plus arthroscopy. This is a retrospective case series of patients who have undergone ankle fracture ORIF +/- arthroscopy from July 2014 to July 2017 inclusive. Each patient’s presenting radiograph was classified according to the Lauge-Hansen ankle fracture classification with subsequent correlation to intra-operative arthroscopic findings. Functional outcome at a minimum of one year was evaluated with the American Academy of Orthopaedic Surgeons (AAOS) metric. Twenty two patients underwent ankle ORIF plus arthroscopy (Group A) with a further 26 patients receiving ORIF alone (Group B). 1 in 3 supination-external-rotation type II (SER II) injuries possessed a concomitant syndesmosis injury or osteochondral lesion (OCL) on arthroscopy. 1 in 3 patients with an SER IV injury had an osteochondral lesion. The mean AAOS score achieved for Group A was 89.6 (±7.9) with the mean score for Group B being 82.0 (±13.7). In conclusion, ankle arthroscopy aids the diagnosis and treatment of ligamentous and osteochondral injuries not evident on plain film with subsequent superior short-term outcomes.