Abstract
Subtalar joint stiffness is an under recognized complication of ankle fractures. We set out to objectively measure its prevalence and impact on Activities of Daily Living (ADL).
Method:
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60 ankle fractures included in study. All patients had contralateral normal ankle.
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M:F=21:39
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Average age: 36 (19 – 84)
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Weber: A B C
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21 27 12
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27 patients underwent ORIF (12C + 15B)
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39 patients had plaster casts for between 2 and 6 weeks. (27B + 12C)
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Postop regimes included early mobilization and POP application (AO recommendation)
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Weber A (21) treated symptomatically.
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Examinations for study at 3/12 and 6/12 post injury.
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Subtalar and ankle movements were assessed by the same examiner (as per Hoppenfeld)
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Subjective questions about subtalar stiffness and their impact on ADL were asked.
Results:
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At 3/12, 56 patients (17A + 27B + 12C) had subjective and clinical impairment of subtalar movement.
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32 patients (2A + 20B + 10C) had moderate to severe impairment (> 30%)
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At 6/12, 42 patients (9A + 23B + 10C) had subjective symptoms and clinical impairment of subtalar function. Of these, 26 (0A + 18B + 8C) had > 30% impairment vs. controls.
Conclusions: Symptomatic subtalar joint stiffness with limitation of ADL is a significant sequel of ankle fractures and results in long term morbidity. This has implications in assessing functional outcome of these common injuries.
Correspondence should be addressed to the Honorary Secretary, BOFSS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
