OPEN ANKLE FRACTURES - THE INDICATIONS FOR IMMEDIATE OPEN REDUCTION AND INTERNAL-FIXATION

Twenty-two patients with open ankle fractures or fracture-dislocations were treated with irrigation and debridement, reduction, and immediat e stable internal fixation at an average of six hours from initial eva luation. There were 13 women (59%) and nine men (41%), having an avera ge follow-up period of 32 months (range, five to 111 months). There we re six Grade I (27%), 15 Grade II (68%), and one Grade III (5%) injuri es. Fractures also were classified according to the Danis-Weber scheme (Type A [three cases]; Type B [eight]; Type C [11]). Excellent result s were achieved in 14 patients (64%); good results in five (23%), and poor results in three (13%). There were four minor complications: two superficial wound ulcerations, one loss of reduction requiring revisio n stabilization, and one distal tibiofibular synostosis. There were no deep infections or nonunions. Immediate debridement, irrigation, redu ction, and internal fixation of open ankle fractures is clearly indica ted in Grade I and clean Grade II open injuries.