Impact of trimalleolar ankle fractures: how do patients fare post-operatively?

BACKGROUND

We aim to evaluate the clinical and functional outcome of trimalleolar fractures and the ability of patients to return to sporting activities.

METHODS

A retrospective review of 31 patients with operatively managed trimalleolar fractures was conducted. Their Olerud and Molander scores and ability to return to sports was analyzed at 1 year postoperatively.

RESULTS

Dislocations were more likely to result from trimalleolar fractures (p<0.001). 11 (52.4%) of our patients had residual pain at 1 year. 13 (61.9%) and 10 (47.6%) had persistent ankle stiffness and swelling. Out of 12 patients who were involved in sports pre-operatively, only 4 (33.3%) patients were able to return to sports. 3 (25%) patients were unable to do sports at all. Increasing posterior malleolar fragment size correlates with poorer functional outcome.

CONCLUSIONS

Patients have poorer functional outcome with increasing posterior malleolar fragment size in trimalleolar fractures. Residual deficits affect the majority of our patients and a notable proportion was unable to return to sporting activities.