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Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_II | Pages 233 - 233
1 Jul 2008
Dalal R Mulgrew E Devarajan G
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Subtalar joint stiffness is an under recognized complication of ankle fractures. We set out to objectively measure its prevalence and impact on Activities of Daily Living (ADL).

Method:

60 ankle fractures included in study. All patients had contralateral normal ankle.

M:F=21:39

Average age: 36 (19 – 84)

Weber: A B C

21 27 12

27 patients underwent ORIF (12C + 15B)

39 patients had plaster casts for between 2 and 6 weeks. (27B + 12C)

Postop regimes included early mobilization and POP application (AO recommendation)

Weber A (21) treated symptomatically.

Examinations for study at 3/12 and 6/12 post injury.

Subtalar and ankle movements were assessed by the same examiner (as per Hoppenfeld)

Subjective questions about subtalar stiffness and their impact on ADL were asked.

Results:

At 3/12, 56 patients (17A + 27B + 12C) had subjective and clinical impairment of subtalar movement.

32 patients (2A + 20B + 10C) had moderate to severe impairment (> 30%)

At 6/12, 42 patients (9A + 23B + 10C) had subjective symptoms and clinical impairment of subtalar function. Of these, 26 (0A + 18B + 8C) had > 30% impairment vs. controls.

Conclusions: Symptomatic subtalar joint stiffness with limitation of ADL is a significant sequel of ankle fractures and results in long term morbidity. This has implications in assessing functional outcome of these common injuries.