Complications of open reduction and internal fixation of ankle fractures

The overall complication rate after open reduction and internal fixation (ORIF) of ankle fractures varies widely in the literature. In a retrospective study [1] of 501 ankle fractures, the rate of early complications after surgical treatment was 5%. Mak et al [2] studied 116 cases; the rate of local complications was 11.6%. Carragee et al [3] and Ebraheim et al [4] reported much higher complication rates of surgically-treated closed ankle fractures, of 30% and 40%, respectively. These different figures can be explained by the different type of fractures and patient populations. Complications after ORIF of ankle fractures can be attributed to patient factors (eg, age, obesity, lowered immunity, diabetes, alcohol abuse, and noncompliance), fracture factors (eg, open fractures, comminution), and iatrogenic factors (eg, poor reduction, penetration of the joint with screws, early removal of syndesmotic screws) [4].