Deformity Correction in Malunited Ankle Fracture the Clinical and Functional Outcomes

Background: Malunion of the ankle fractures is a frequent cause of morbidity. The normal ankle is essential for normal mobility. Objective: To evaluate the functional outcome of surgical correction of malunited ankle fractures. Methods: This was a retrospective, cross-sectional hospital-based study conducted at Bashaeir University Hospital between January 2019 and March 2023. The study sample was 40 patients fulfilled the inclusion criteria of the study. Patient timeline included initial fracture fixation, subsequent diagnosis of malunion during follow-up, and definitive corrective surgery. Surgical delay was defined as the interval between initial injury and primary fixation, and this definition was applied consistently across analyses. Functional outcome was measured using the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Score. Results: The mean age of the patients was 42.5 ± 12.3 years, with a male-to-female ratio of 1.5:1. The mean follow-up duration was 32.4 ± 10.1 months. The mean AOFAS Ankle-Hindfoot Score at final follow-up was 78.6 ± 16.2. Good-to-excellent functional outcomes were achieved in 27 patients (67.5%), while 13 patients (32.5%) had fair-to-poor outcomes. Postoperative complications occurred in 8 patients (20.0%), most commonly symptomatic post-traumatic osteoarthritis (17.5%). One patient (2.5%) had a superficial surgical site infection. Good-to-excellent functional outcomes were significantly associated with Weber Type B fractures, shorter surgical delay (≤ 7 days), and absence of talar shift (p < 0.05). Conclusion: The study concluded that a good functional outcome with few postoperative complications after surgical correction of malunited ankle fractures at Bashaeir University Hospital during the study period was dominant and indicated that osteotomy, fusion, and open reduction and internal fixation in the surgical treatment of malunited ankle fractures are effective with few postoperative complications.