Soft-tissue swelling following fractures of the ankle.

One hundred and thirty-six consecutive fractures of the ankle were assessed over a 2-year follow-up period in order to determine the rate at which soft-tissue swelling subsides. The effect of anatomical and non-anatomical reduction by both open and closed methods was compared. The results showed that soft-tissue swelling following external rotation fractures of the lateral malleolus treated by closed methods subsides initially over a 3-month period. Anatomical reduction, whether achieved by open or closed methods, in bi- and trimalleolar fractures results in a rapid resolution of the swelling over 3 months, followed by a slower return to normal over the ensuing 6 months. Persistent soft-tissue swelling remains when these intra-articular fractures are not anatomically reduced. The swelling is more marked and persists for 2 years or more in those fractures treated by open methods with poor anatomical restoration compared with poor reduction achieved by closed methods.