Efficacy of full ankle arthroscopy in treatment of Tillaux-Chaput fractures

Objective To investigate the clinical result of treating Tillaux-Chaput fractures using the full ankle arthroscopy technique. Methods A retrospective analysis was made on 21 patients with Tillaux-Chaput fractures followed up after treatment by the full ankle arthroscopy technique from May 2013 to May 2015. There were 16 males and 5 females, with the age range of 6-55 years [(25.5±12.8)years]. Right ankle was involved in 12 patients and left ankle in 4 patients. Sixteen patients had single Tillaux-Chaput fractures and 5 patients had combined proximal fibular fractures. Diagnosis of Tillaux-Chaput fractures was confirmed by X-rays in 18 patients an CT in 3 patients. Ankle arthroscopy was used through the anterolateral and anteriormedal approaches for closed reduction and internal fixation using one or two Herbert screws. Wound healing, bone union and visual analogue score (VAS) were detected postoperatively. Function assessment was performed using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring system. Results All incisions healed by first intention, without evidence of nerve, vessel and tendon injuries. Period of follow-up was (15.3±7.1)months (range, 12-25 months). Fracture healed within 12 to 36 weeks [(22.6±4.6)weeks] after operation.VAS was (0.8±0.3)points after operation, obviously lower than preoperative (8.3±1.3)points (P<0.05). At the final follow-up, all patients regained normal ankle function and normal walking gait, without the presence of ankle pain and weight-bearing walking pain. AOFAS score was improved from preoperative (51.2±12.5)points to postoperative (92.7±16.5)points (P<0.05). Based on the AOFAS score, the results were excellent in 19 patients and good in 2 patients, with the excellent-good rate of 100%. Conclusion Full ankle arthroscopy by the anterolateral and anteriormedal approaches provides a precise and effective method for closed reduction and internal fixation of Tillaux-Chaput fractures and deserves clinical application. Key words: Ankle injuries; Arthroscopes; Surgical procedures, minimally invasive