E.: Early complications in the operative treatment of ankle fractures. Influence of delay before operation

We have reviewed the early complications of 121 surgically treated closed ankle fractures; the complication rate was 30%, with 14 major and 22 minor complications. Fractures with skin blisters or abrasions had more than double the overall complication rate. Fracture-dislocations had three times as many major complications as simple fractures, and those not fixed within 24 hours had a 44 % major complication rate compared to 5.3 % in those operated upon as emergencies. Patients transferred from another medical facifity had high complication rates, especially if they had fracture-dislocations. We conclude that operative treatment of anide fractures must be delivered in a timely fashion, especially in severe fractures. We would caution against the practice of transferring patients with serious ankle fractures before completion of definitive care. Reported complication rates for operative treatment of ankle fractures vary widely (Burwell and Charn!ey 1965; Hughes et a! 1979; Wilson 1984; Phillips et al 1985; Shelton and Anderson 1986; Fogel and Morrey 1987)