Arthroscopy may help detect occult pathology in open treatment of ankle fractures
The addition of ankle arthroscopy to open treatment of ankle fractures may be used to detect and treat occult pathology with a low complication rate, according to study results.
Hibba Aziz, MD, and colleagues collected patient demographics and clinical history among 84 patients with ankle fracture who underwent open reduction and internal fixation with adjunctive ankle arthroscopy from August 2010 to October 2019. Researchers noted preoperative and postoperative diagnoses from every operative report and intra-articular intervention made during the time of arthroscopy.
Results showed the addition of ankle arthroscopy detected new diagnoses in 75% of patients, with the most common new pathology being osteochondral lesions (41.9%) and posterior malleolus fractures (32.6%). In conjunction with fracture management, researchers found 34 patients had 40 additional arthroscopic procedures, including partial synovectomy, loose body excision, microfracture and chondroplasty. Researchers identified complications in 13 patients, with the most common being hardware removal (62%).
“As outcome data suggests, despite anatomic reduction and appropriate treatment, patients often develop chronic pain and posttraumatic degenerative changes in their ankle after sustaining an ankle fracture. We hope that our study can shed some light on the importance of ankle arthroscopy as an adjunct to the management of ankle fractures,” Aziz told Healio Orthopedics. “Although there is a need for well-powered, prospective, randomized controlled trials to truly prove the efficacy of ankle arthroscopy’s role in ankle fractures, we hope that our study is a starting point to show that this management is legitimate, low-risk [and] relatively inexpensive, and should become part of our armamentarium when managing patients with ankle fractures.”