Rate of Return of Functional Outcome After Open Reduction and Internal Fixation of Unstable Ankle Fractures

In the prospective cohort study reported here, we used the Short Musculoskeletal Function Assessment (SMFA) questionnaire to assess rate of return of functional outcome after open reduction and internal fixation of unstable ankle fractures (Orthopaedic Trauma Association/Arbeitsgemeinschaft für Osteosynthesefragen [OTA/AO] 44B and 44C) at a level II trauma center over the course of 1 year.

The entire group of 69 consecutive adults improved significantly (P<.01) on the SMFA Emotional Status and Dysfunction scales from 2 to 4 months and on the Mobility and Daily Activities scales from 2 to 4 months and from 4 to 6 months. There were no significant changes on the Arm/Hand Function and Bother scales. There was a significant effect of age on Mobility, Daily Activities, and Dysfunction, with older patients (≥50 years) obtaining higher (worse) scores. There was no significant effect on patient sex on any of the scales. Patients with 44C fractures (vs 44B fractures) had significantly (P = .05) higher mean Bother scores at 6 months. There were no significant differences arising from presence or absence of a fracture of the medial malleolus.

Our SMFA data show that older patients (≥50 years) and patients with 44C fractures had slower return to maximal function and higher Bother scores at 6 months. All groups reached a relatively stable functional outcome by 6 months after injury, but their mobility did not return to population norms over the same period.