Preliminary effect of posterolateral ankle arthroscopy for ankle fractures in elderly patients

Objective: To investigate the therapeutic effect of posterolateral approach to ankle arthroscopy in management of ankle fractures. Methods: Between March 2014 and May 2016, 68 patients with ankle fractures treated in our hospital were enrolled as subjects and randomly assigned to receive either standard open reduction (the control group, n=34) or the posterolateral approach to ankle arthroscopy (the experimental group, n=34). Therapeutic effect, operative time, intraoperative bleeding and postoperative recovery time were compared between the two groups. Ankle joint functions before and after surgery were assessed using the McGuire scoring system; and the patients’ pain recovery was assessed using the pain visual analog scale (VAS). Results: The differences in good-excellent results (73.5% vs 35.3%) and qualified results (91.2% vs 70.6%) between the two groups were statistically significant (P=0.000); and the operative time, intraoperative bleeding and postoperative recovery time were significantly reduced in the experimental group as compared with the control group (52.1 ± 9.8 min vs 74.1 ± 9.2 min, 60.7 ± 14.5 ml vs 210.8 ± 54.2 ml, 6.6 ± 1.3 d vs 10.9 ± 1.5 d, respectively). After surgery, the amplitude of improvement in McGuire score of ankle joint function was significantly greater in the experimental group than in the control group (35.3 ± 2.8 vs 22.6 ± 2.5, P=0.000), and the VAS scores in the experimental group were superior to those of the patients in the control group (2.8 ± 1.05 vs 4.1 ± 1.2, P=0.000). Conclusion: The posterolateral approach to ankle arthroscopy for management of ankle fractures is advantageous over standard open reduction in the following aspects: better therapeutic effect, shorter operation time, less intraoperative bleeding, shorter postoperative recovery time. Thus, it is worthy of extensive clinical application.