Postoperative Radiographs as Predictors of Clinical Outcome in Unstable Ankle Fractures

Abstract

Summary This study reviews a group of 80 consecutive displaced ankle fractures treated operatively and followed for an average of 3.2 years. Fractures included bone or combined bone and ligamentous injuries in which the initial talar displacement was 2 mm. The immediate postoperative roentgenograms were examined for several features, which included widening of the syndesmosis, fibular length, talo-crural angle, talar tilt, presence and size of a posterior malleolar fracture, and an abnormality of the medial clear space. Patients were examined at follow-up per Cedell, and their clinical evaluations were correlated with the analysis of radiographic features and demographic data. Good to excellent results were seen in 80% of the cases. The radiographic factors most predictive of a poor outcome were abnormal medial clear space and the presence of a large (>20%) posterior malleolar fracture (p 7 days tended to have a poorer result.