Abstract
The aim of this literature review is to systematically gather the highest level of
available evidence on the long-term outcome after operatively treated ankle fractures
in the English, German and Dutch literature. A search term with Boolean operators
was constructed. The search was limited to humans and adults and the major databases
were searched from 1966 to 2008 to identify studies relating to functional outcome,
subjective outcome and radiographic evaluation at least 4 years after an operatively
treated ankle fracture. Of the 42 initially relevant papers, 18 met our inclusion
criteria. A total of 1822 fractures were identified. The mean sample-size weighted
follow-up was 5.1 years. The initial number of patients that were included in the
studies was 2724, which results in a long-term follow-up success rate of 66.9%. Regarding
the fracture reduction we found 4 papers reporting on 106 fractures. Of the fractures
that were classified according to Danis–Weber, 736 were eligible for correlation with
the long-term outcome. In 442 fractures a comparison was possible between supination–external
rotation stage 2 and 4 of the Lauge-Hansen classification. Only one study reported
on the influence of initial cartilage lesions on the outcome. Regarding the involvement
of the posterior malleolus, two studies reported on the long-term outcome. None of
the studies addressed the influence of hindfoot varus or valgus on the long-term outcome
after ankle fracture. Only 79.3% of the optimally reduced fractures show good to excellent
long-term outcome. The Weber A type fractures do not show a better long-term outcome
than Weber B type fractures. Recommendations for future research were formulated.
Keywords
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Article info
Publication history
Accepted:
April 7,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
