Ankle arthroscopy to manage sequelae after ankle fractures

Verfasser / Beitragende:
[Edward Dawe, Christopher Jukes, Kumar Ganesan, Alexander Wee, Nikolaos Gougoulias]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/11(2015-11-01), 3393-3397
Format:
Artikel (online)
ID: 605460647
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024 7 0 |a 10.1007/s00167-014-3140-0  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-3140-0 
245 0 0 |a Ankle arthroscopy to manage sequelae after ankle fractures  |h [Elektronische Daten]  |c [Edward Dawe, Christopher Jukes, Kumar Ganesan, Alexander Wee, Nikolaos Gougoulias] 
520 3 |a Purpose: The role of ankle arthroscopy in managing the consequences of ankle fractures is yet to be fully established. This study aims to assess this procedure in terms of the accuracy of preoperative diagnosis, re-operation rate and patient-reported outcomes. Methods: Sixty-six patients were identified [mean age 40years (SD 13years)] who had undergone ankle arthroscopy following a fracture of the distal tibia or fibula. Medical case notes were reviewed to ascertain details of the index injury, intra-operative findings and identify any further procedures. Patients were then contacted using a standardized questionnaire to assess satisfaction and return to normal function. Results: Injury occurred in a mean of 2years 10months before arthroscopy (SD 13months, min 6months). Forty-nine of 66 fractures (74%) had been managed operatively. The commonest indication for arthroscopy was anterior impingement (45%) followed by degenerative change (30%) and osteochondral lesions (OCL) (18%). Intra-operative findings revealed an unexpected OCL or frank degenerative change in 20% of patients. Using a Kaplan-Meier estimate 1year after arthroscopy, 10% of patients had undergone further surgery. This had increased to 34% by 4years after arthroscopy. Four patients underwent ankle fusion. Questionnaires were completed by 55/66 patients (84%). Only 28 patients (50%) felt surgery allowed them to return to normal activity. Thirty-nine patients reported a benefit from surgery (75%) whilst 43 were satisfied (77%) and 48 (86%) would recommend the procedure to a friend. Conclusions: Intra-articular pathology was significantly underestimated preoperatively for one patient in five. Arthroscopy improved symptoms in 75% of patients who complain of ankle symptoms after fracture of the ankle or distal tibia. However, further procedures were required in 34% of patients. The findings of this study help guide patient counselling and operative decision-making in this challenging group of patients. Level of evidence: IV. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Ankle arthroscopy  |2 nationallicence 
690 7 |a Osteochondral lesion  |2 nationallicence 
690 7 |a Talar dome  |2 nationallicence 
690 7 |a Instability  |2 nationallicence 
700 1 |a Dawe  |D Edward  |u Frimley Park Hospital, Camberley, Surrey, UK  |4 aut 
700 1 |a Jukes  |D Christopher  |u Frimley Park Hospital, Camberley, Surrey, UK  |4 aut 
700 1 |a Ganesan  |D Kumar  |u Frimley Park Hospital, Camberley, Surrey, UK  |4 aut 
700 1 |a Wee  |D Alexander  |u Frimley Park Hospital, Camberley, Surrey, UK  |4 aut 
700 1 |a Gougoulias  |D Nikolaos  |u Frimley Park Hospital, Camberley, Surrey, UK  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/11(2015-11-01), 3393-3397  |x 0942-2056  |q 23:11<3393  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-3140-0  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-3140-0  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Dawe  |D Edward  |u Frimley Park Hospital, Camberley, Surrey, UK  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Jukes  |D Christopher  |u Frimley Park Hospital, Camberley, Surrey, UK  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ganesan  |D Kumar  |u Frimley Park Hospital, Camberley, Surrey, UK  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Wee  |D Alexander  |u Frimley Park Hospital, Camberley, Surrey, UK  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Gougoulias  |D Nikolaos  |u Frimley Park Hospital, Camberley, Surrey, UK  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/11(2015-11-01), 3393-3397  |x 0942-2056  |q 23:11<3393  |1 2015  |2 23  |o 167