Arthroscopic findings in acute fractures of the ankle

We have evaluated prospectively the arthroscopic findings in acute fracture s of the ankle in 288 consecutive patients (148 men and 140 women) with a m ean age of 45.6 years. According to the AO-Danis-Weber classification there were 14 type-A fractures, 198 type B and 76 type C, Lesions of the cartilage were found in 228 ankles (79.2%), more often on th e talus (69.4%) than on the distal tibia (45.8%), the fibula (45.1%), or th e medial malleolus (41.3%), There were more lesions in men than in women an d in general they were more severe in men (p < 0.05). They also tended to b e worse in patients under 30 years and in those over 60 years of age, The f requency and severity of the lesions increased from type-B to type-C fractu res (p < 0.05). Within each type of fracture the lesions increased from sub groups 1 to 3 (p < 0.05). The anterior tibiofibular ligament was injured wi th increased frequency from type-B,1 to type-C.3 fractures (p < 0.05), but it was not torn in all cases. While lateral ligamentous injuries were seen more often in type-B than in type-C fractures (p < 0.05), no difference was noted in the frequency of deltoid ligamentous lesions. Our findings show that arthroscopy is useful in identifying associated intr a-articular lesions in acute fractures of the ankle.