Functional Outcome after Operative Treatment for Ankle Fractures in Young Athletes: A Retrospective Case Series

Abstract

Background: No reports describe the outcome for distal fibula and tibia fractures in athletes, although 10 to 15% of all athletic injuries occur around the ankle joint. Materials and Methods: Forty-seven competitive or recreational athletes with ankle fractures underwent open reduction and internal fixation (ORIF). Thirty-six met the inclusion criteria, of which 27 returned for clinical and radiographic exams and also completed validated surveys and a subjective questionnaire. Results: Nineteen of the 27 were male. The average age of all patients was 18.1 ± 5.9 years. The final evaluations occurred 12 months to 3.7 years after surgery. Injuries occurred in 13 different sports, of which football had the most ( n = 10). Bimalleolar fractures were the most prevalent ( n = 10) followed by isolated lateral malleolar fractures ( n = 6), syndesmosis injury ( n = 4), Salter-Harris ( n = 4), medial malleolar fracture ( n = 2) and pilon fracture ( n = 1). The patients with isolated lateral malleolar fractures returned to competition soonest (6.8 ± 2.4 weeks) while patients with isolated medial malleolus fractures took the longest to return at a mean of 17.0 ± 9.9 weeks. Scores for function and pain on the Lower Limb Core Module and for pain on the Foot and Ankle module were all greater than 90. Conclusion: Athletes who undergo ORIF followed by early motion and early weightbearing are able to return to their pre-injury level of competition within 2 to 4 months with minimal functional morbidity or pain.