Arthroscopy can help detect occult pathology in open treatment of ankle fractures

Adding ankle arthroscopy to open treatment for ankle fractures can be used to detect and treat occult pathology with a low rate of complications, according to the study results.

Hibba Aziz, MD, and colleagues collected patient demographics and clinical history among 84 ankle fracture patients who underwent open reduction and internal fixation with adjunct ankle arthroscopy from August 2010 to October 2019. The researchers noted the preoperative and postoperative diagnoses of each operative report and intra-articular intervention performed during the time of arthroscopy.

The results showed that the addition of ankle arthroscopy detected new diagnoses in 75% of patients, the most common new pathology being osteochondral lesions (41.9%) and posterior malleolus fractures ( 32.6%). In conjunction with the management of the fractures, the researchers found that 34 patients had undergone 40 additional arthroscopic procedures, including partial synovectomy, loose body excision, microfracture, and chondroplasty. The researchers identified complications in 13 patients, the most common being the removal of material (62%).

Hibba Aziz

“As the outcome data suggest, despite anatomical reduction and appropriate treatment, patients often develop chronic pain and post-traumatic degenerative changes in the ankle after sustaining an ankle fracture. We hope our study can shed light on the importance of ankle arthroscopy as an adjunct to the management of ankle fractures, ”Aziz told Healio Orthopedics. “While there is a need for prospective, high-powered, randomized controlled trials to truly prove the effectiveness of the role of ankle arthroscopy in ankle fractures, we hope our study will be a point of reference. departure to show that this support is legitimate and low risk. [and] relatively inexpensive and should be part of our arsenal when caring for patients with ankle fractures. “