Audit of ankle fracture patients attended at Muhimbili orthopaedic institute; Their management and early treatment outcome

Ankle fractures are some of the common and complex fractures of lower limb, and if not managed properly havesignificant functional impairment. Currently the standard treatment for unstable injuries is ORIF and stable one by non operative measures in many centers. Ankle fractures at MOI have been managed by these methods though anecdotal experience has been positive, the outcome of treatment has not been scientifically evaluated. Objectives: We evaluated the characteristics, management and short-term outcome of patients with ankle fractures attended at MOI in 2012. Methodology: A cross sectional study was done on adult patients with ankle fractures attended at MOI. Forty one patients met the study inclusion criteria of these 7 were lost to follow up, leaving 34 patients for evaluation. The researcher used a structured questionnaire to collect data from the participants. These patients were followed up immediately post treatment, then at 6th, 12th and 16th week. X-rays radiographs and AOFAS score were assessed. Each patient was followed up for a minimum of 16 weeks. The obtained data was analyzed by SPSS version 15. Results Thirty four patients were admitted in the study: 24 (70.6%)men and 10 (29.4%) women. The average AOFAS score at the 16th week after treatment was 80 ( range 55 to 100). Taking classification of ankle fractures into consideration, 85.7% patients with Weber A fractures, 68.75% of Weber B fractures, and and 45.45% of Weber C fractures achieved a ‘good’ to ‘excellent’ outcome at the 16th week of follow up, 27.3% of Weber C, and 18.8% Weber B had poor outcome. There was no difference in AOFAS scores between the groups. Conclusion. Ankle fractures are a significant problem at MOI, with trauma due to road traffic crush being the main cause followed by falling and twisting, mostly affecting economically active patients aged between 25-59 years. Majority of these patients had primary and secondary education only (82%) and self employed in petty businesses and peasants. The functional outcome for patients who suffer ankle fracture is relatively good, (64.7% had a good to excellent) results. However some of the patients who sustained ankle fractures have significant functional impairment even at 16th week of followup