DOS 2018

DOS Kongressen 2018 · 233 Complication and reoperation rates following fixation of posterior malleolar fractures - a retrospective cohort study Catarina Malmberg, Jonas Frederiksen, Anders Troelsen, Ilija Ban, Peter Toft Tengberg, Mads Terndrup Department of Orthopedics, Copenhagen University Hospital Hvidovre Background: Operative management of the posterior malleolus (PM) in ankle fracture osteosynthesis is an object of increasing attention. Purpose / Aim of Study: To examine potential risk factors and complication rates after osteosynthesis of ankle fractures involving the PM. Materials and Methods: Adult patients with ankle fractures treated surgically from June 2011 to December 2015 at our institution were assessed for eligibil- ity. Exclusion criteria were: non-danish citizen, non-operative treatment, treat- ment >4 weeks after injury or staged procedures, follow-up at an alternative institution, and patients lost to follow-up. Demographics and injury-related risk factors, as well as procedural data, were recorded and fractures were classi- fied from standard radiographs and, if present, CT-scans. Postoperative data included immobilization regimen, access to physiotherapy, complications, un- planned reoperation, and implant removal. Minimum follow-up was 18 months in all cases. Findings / Results: 764 patients were eligible for review and 367 patients had PM involvement. In 61 patients the PM was fixed, most commonly with ante- rior to posterior percutaneous screws. 84% of patients were not allowed full weightbearing from day one. The overall complication rate after ORIF of ankle fractures with PM involvement was 20.7%, with a reoperation rate of 10.6%, not including implant removal. 20 of the 61 patients who received operative PM fracture fixation suffered complications (32.8%) and 18% required reoperation. Conclusions: Patients with ankle fractures involving the PM seem to have a high risk of complication and 10% require reoperation. Although the severity of the injury is a clear selection bias in the group receiving operative fixation of PM fractures, complications in one third of cases seems unacceptably high, calling for further investigation in prospective studies. 174.