Effect of Talocrural angle Variation on Short Term Outcomes of Operatively Managed Ankle Fractures

Abstract

Background: Ankle injuries are among the most frequent orthopedic consults accounting around 15% of all orthopedic emergency visits. Operatively managed ankle fractures represent 2% of all fractures. Many radiological features are taken into consideration while evaluating ankle fractures. This study aimed to evaluate the effect of preoperative and post-operative talocrural angle (TCA) on short term outcomes of operated ankle fractures in Kigali public referral hospitals, and relationship to other radio graphical features of the ankle. Methodology: After approval by our institutional review board (IRB), A cross-sectional study was carried out in two public referral hospitals in Kigali. We recruited adult patients operated for ankle fractures. Talocrural angle and associated radio graphical features were measured pre and post operatively. A phone interview was conducted after 6 months (from operation date). Olerud Molander Ankle Score (OMAS) was calculated for everyone. T-test or non-parametric tests were used to study the relationship between the predictors and outcome (OMAS) and multiple linear regression analysis was done to further study the relationship between independent variables and the outcomes. Results: Among 45 patients were operated for ankle fractures, 39 patients responded to the interview calls. The mean age was 42 +/- 13.5 years. 56% were female and 44% were male. Bimalleolar fractures are most predominant with 67%, and most likely to have abnormal TCA with 77% preoperatively and 27% post operatively. The mean preoperative TCA was 86.6 degrees, and post-operative TCA 82.6 degrees. Type of fracture, pattern of fracture, abnormal preoperative TCA and post-operative TFO were factors identified to affect outcomes by OMAS with P-values of 0.048, 0.012, 0.025 and 0.016 respectively. Conclusion: Talocrural angle, Tibio-fibular overlap, pattern and type of fracture can have a considerable effect on short term outcomes of operated ankle fractures by OMAS.