Objective and Subjective Clinical Outcomes Following Ankle Fracture: Differences Between Fracture Classification and Controls

Purpose: Ankle fractures are one of the most common injuries of the lower limb. There is, however limited information regarding differences in gait patterns and clinical symptoms between fracture severity classifications. The purpose of the current study was to examine objective and subjective differences between three severity groups of ankle fractures patients compared to healthy controls. Methods: This was a case-controlled prospective study. 92 patients with an ankle fracture injury of which 41 patients were eligible to participate in the study. 24 healthy people served as controls. All patients underwent a computerized gait test, completed self-assessment questionnaires (The Foot and Ankle Outcome Score (FAOS) and the SF-36), evaluated with the American Foot and Ankle Score (AOFAS) form and completed the 6-min walk test. The control group performed a computerized gait test and completed the SF-36 health survey. Results: All ankle fracture patients presented compromised gait patterns and limb symmetry compared to controls (P<0.05). Ankle fracture patients also had lower SF-36 scores compared to controls (P<0.05). Significant differences were found between the unimalleolar group compared to the bimalleolar and trimalleolar groups in most parameters, except for the FAOS scores. There were no significant differences between the bimalleolar fracture group and the trimalleolar fracture groups. Conclusions: Although all fracture severity classification groups presented a compromised gait pattern and worse clinical symptoms compared to controls, it seems that patients with a unimalleolar fracture is a different group compared to bimalleolar and trimalleolar fracture. Furthermore, it seems that bimalleolar fracture and trimalleolar fracture affect the gait pattern and clinical symptoms to an equal extent, at least in the short-term.