COMPARATIVE ANALYSIS OF CONSERVATIVE AND OPERATIVE TREATMENT STRATEGIES FOR ANKLE FRACTURES: A 12-MONTH PROSPECTIVE STUDY
DOI:
https://doi.org/10.48047/z14dz347Keywords:
Ankle fracture, Open reduction internal fixation, Conservative treatment, Functional outcomeAbstract
Background: Ankle fractures are among the most frequently encountered musculoskeletal injuries in orthopedic practice and represent a significant cause of morbidity across all age groups. The management of ankle fractures depends largely on fracture stability, displacement, associated ligamentous injury, and patient-related factors. Stable fractures are often treated conservatively with immobilization and protected weight-bearing, whereas displaced or unstable fractures commonly require surgical fixation to restore anatomical alignment and joint congruity. Despite established treatment principles, comparative evidence regarding functional outcomes and complication profiles remains important for optimizing treatment selection and patient care. Objectives: To compare the functional outcomes, fracture union rates, and complications associated with conservative and surgical management of ankle fractures. Methods: This prospective comparative study included 150 patients diagnosed with ankle fractures and treated according to standard clinical indications based on fracture stability and displacement. Patients underwent either conservative treatment with immobilization or surgical fixation using appropriate operative techniques. Clinical and radiological follow-up was conducted for 12 months. Functional outcomes were assessed using the Olerud–Molander Ankle Score (OMAS) and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Fracture union and treatment-related complications were evaluated. Statistical comparisons were performed using t-tests and chi-square tests, while multivariable analyses adjusted for fracture pattern and baseline demographic and clinical characteristics. Results: Both treatment groups demonstrated satisfactory fracture healing and significant functional improvement at 12 months. Surgical management resulted in significantly higher functional scores and lower rates of malunion among patients with displaced or unstable fractures. However, surgical treatment was associated with a greater incidence of wound-related complications. Stable fractures treated conservatively achieved favorable outcomes comparable to operative management. Conclusion: Individualized treatment based on fracture stability provides excellent outcomes in ankle fractures. Surgical fixation offers superior results for displaced or unstable injuries, whereas conservative management remains an effective option for stable fractures. These findings support an indication-based approach to optimize functional recovery and minimize complications.
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