摘要
Background:Acute ankle fractures can lead to high rate of concomitant intra-articular lesions which may compromise clinical results.The purpose of this study was to evaluate the Prevalence of concomitant intra-articular lesions in acute ankle fractures with arthroscopy.We also sought to analyze the relationship between intra-articular lesions and the fracture type,as well as the severity of the fracture.Methods:It was a retrospective cohort study.From April 2014 to December 2015,we have chosen arthroscopy-assisted open reduction and internal fixation (AORIF) for the treatment of unstable acute ankle fractures.All concomitant intra-articular lesions were assessed and documented carefully and prospectively,such as ligament injuries,osteochondral lesions,and tibiofibular syndesmosis injuries.All fractures were classified according to the Lauge-Hansen classification system.The American Orthopedic Foot and Ankle Society's (AOFAS) ankle-hindfoot scale was used to assess post-operative function.Statistical comparisons between the intra-articular lesions,the fracture type,and the severity of the presenting fracture were performed using a Chi-squared analysis.Results:Data of 36 patients were analyzed in the study,including 23 supination-type fractures and 13 pronation-type fractures.The incidence of tibiofibular syndesmosis injuries,chondral lesions,and loose bodies were 92%,72%,and 39%,respectively.Avulsion fractures of the anterior tibiofibular syndesmosis were more commonly found in supination-type fractures than pronation-type fracture (45% vs.15%,x2 =5.78,P =0.02),which would cause mechanical blocking in the anterior portion of the ankle.On the contrary,chondral lesions were more commonly found in the more severe fractures than mild fractures (86% vs.53%,x2 =4.57,P =0.03).A mean 41.7 months (range,33.0-51.0 months) of follow-up was achieved.A mean AOFAS's ankle-hindfoot scale was 96.9,and 97.2% of the patients were satisfied with the procedure.Conclusions:Acute ankle fractures have a high incidence of concomitant int
