Published online Apr 18, 2016. doi: 10.5312/wjo.v7.i4.258
Peer-review started: May 11, 2015
First decision: July 27, 2015
Revised: December 10, 2015
Accepted: January 5, 2016
Article in press: January 7, 2016
Published online: April 18, 2016
Processing time: 338 Days and 20.2 Hours
AIM: To report ankle fracture configurations and bone quality following arthroscopic-assisted reduction and internal-fixation (ARIF) or open reduction and internal-fixation (ORIF).
METHODS: The patients of ARIF (n = 16) or ORIF (n = 29) to treat unstable ankle fracture between 2006 and 2014 were reviewed retrospectively. Baseline data, including age, sex, type of injury, immediate postoperative fracture configuration (assessed on X-rays and graded by widest gap and largest step-off of any intra-articular site), bone quality [assessed with bone mineral density (BMD) testing] and arthritic changes on X-rays following surgical treatments were recorded for each group.
RESULTS: Immediate-postoperative fracture configurations did not differ significantly between the ARIF and ORIF groups. There were anatomic alignments as 8 (50%) and 8 (27.6%) patients in ARIF and ORIF groups (P = 0.539) respectively. There were acceptable alignments as 12 (75%) and 17 (58.6%) patients in ARIF and ORIF groups (P = 0.341) respectively. The arthritic changes in follow-up period as at least 16 wk following the surgeries were shown as 6 (75%) and 10 (83.3%) patients in ARIF and ORIF groups (P = 0.300) respectively. Significantly more BMD tests were performed in patients aged > 60 years (P < 0.001), ARIF patients (P = 0.021), and female patients (P = 0.029). There was no significant difference in BMD test t scores between the two groups.
CONCLUSION: Ankle fracture configurations following surgeries are similar between ARIF and ORIF groups, suggesting that ARIF is not superior to ORIF in treatment of unstable ankle fractures.
Core tip: There was no significant difference between arthroscopic-assisted reduction and internal-fixation (ARIF) and open reduction and internal-fixation (ORIF) in immediate-postoperative ankle fracture configuration in the present study. Although the use of arthroscopy in orthopaedic trauma is increasing, the effectiveness of ARIF compared with that of ORIF in the management of ankle fractures has yet to be verified. The low rate of bone mineral density testing reflects a lack of awareness of the need for routine post-injury testing for osteoporosis in patients with ankle fractures.