![]() The Swedish Fracture Register (SFR) is a national quality register of all types of fractures treated by orthopedic surgeons, both surgically and non-surgically (4). Understanding whether an ankle fracture is stable or unstable in the ankle mortise is essential for further decision-making regarding management and treatment (2, 3). The AO/OTA classification considers both fractures and ligamentous injuries and thus reflects stability. ![]() Transsyndesmotic lateral malleolar ankle fractures are considered stable or unstable in the ankle mortise, depending on the presence or absence of fracture or ligamentous injury to the medial aspect of the ankle (1). The current study demonstrates that a structured treatment algorithm can standardize the management of ankle fractures and make decisions less dependent on the surgeon’s discretion.Īnkle fractures are defined as fractures to one or more of the malleoli, combined or not, with injuries to adjacent ligaments. ConclusionsĪ thoroughly implemented treatment algorithm can reduce the number of surgical treatments for stable ankle fractures. In all the studied parameters regarding treatment for AO/OTA44-B1 fractures, a statistically significant change was seen after the introduction of the TA. The current study is an uncontrolled, non-randomized, retrospective before-and-after study comparing a group of AO/OTA44-B1 fractures treated at SU before the introduction of the TA for ankle fractures (1 April 2012 to 31 March 2014) with a group treated after the introduction of the TA (1 September 2017 to 31 August 2019). We investigated the effects of this well-implemented TA on the classification, treatment and follow-up of lateral malleolar fractures. The study resulted in the development of a structured treatment algorithm (TA) for ankle fractures. In 2015 a study of isolated lateral malleolar fractures (AO/OTA44-B1) treated at Sahlgrenska University hospital (SU) during two consecutive years revealed large-scale variation in the choice of treatment and planned follow-up. ![]()
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