Operative Fixation of Ankle Fractures: The Effect of Time to Surgery onLength of Stay and Soft Tissue Complication Rates

Introduction: There is little evidence consensus on the optimum timing for surgical fixation of closed ankle fractures. This powered study compared rates of soft tissue complications in patients operated on within 24 hrs, at 24-48 hrs, or beyond 48 hours from injury. Materials and Methods: In this retrospective study, N=160 adults with closed ankle fractures were categorised by time to surgery ( 48 hrs), and post-operative complication rates were compared (power 0.85). Results: Soft tissue complications were higher following surgery at 24-48 hrs (15%) vs. surgery after 48 hrs (3.6%), P 0.051. There was no other significant difference in any complication rates. The length of hospital stay postoperatively did not differ between groups. Conclusion: Surgery within 24-48 hours from injury resulted in higher rates of minor soft tissue complications. Further research is necessary to confirm these findings, and to quantify soft tissue swelling and its effect on postoperative complications.