Tuesday, April 6, 2010
Arthroscopy for ankle fractures?
When is ankle arthroscopy recommendable for ankle fractures? There are two randomized studies published on the use of arthroscopy in ankle fractures. One study demonstrated better results in patients who underwent arthroscopy at the time of open reduction internal fixation and the second study demonstrated equivalent results. Based on this data, I do not perform an ankle arthroscopy on all patients who have had an ankle fracture. With patient specific factors also considered, I tend to perform the arthroscopy on higher energy injuries, such as ankle subluxations or dislocations or syndesmosis injuries. At the time of arthroscopy, Ferkel reported a high rate of damage to the articular surfaces following ankle fractures, and my experience supports this fact. At the time of arthroscopy, loose bodies of cartilage alone or a combination of cartilage and bone can be treated, and the joint is looked at thoroughly to identify and treat any other associated injuries. This damage to the inside of the joint can be a cause of chronic pain if left untreated.