Impact of trimalleolar ankle fractures: how do patients fare post-operatively?

Abstract

Background: We aim to evaluate the clinical and functional outcome of trimalleolar fractures and the ability of patients to return to sporting activities.

Methods: A retrospective review of 31 patients with operatively managed trimalleolar fractures was conducted. Their Olerud and Molander scores and ability to return to sports was analyzed at 1 year postoperatively.

Results: Dislocations were more likely to result from trimalleolar fractures (p<0.001). 11 (52.4%) of our patients had residual pain at 1 year. 13 (61.9%) and 10 (47.6%) had persistent ankle stiffness and swelling. Out of 12 patients who were involved in sports pre-operatively, only 4 (33.3%) patients were able to return to sports. 3 (25%) patients were unable to do sports at all. Increasing posterior malleolar fragment size correlates with poorer functional outcome.

Conclusions: Patients have poorer functional outcome with increasing posterior malleolar fragment size in trimalleolar fractures. Residual deficits affect the majority of our patients and a notable proportion was unable to return to sporting activities.

Keywords: Functional outcome; Posterior malleolar fracture; Return to sports; Trauma; Trimalleolar ankle fracture.