Soft tissue problems in ankle fractures treated surgically. A prospective study of 154 consecutive closed ankle fractures.

We performed a prospective registration of primary soft tissue injuries and perioperative soft tissue complications the first 3 months after surgery in ankle fractures treated by open reduction and internal fixation. Open fractures and polytraumatized patients were excluded. The 154 consecutive patients (90 women) with an average age of 54.5 (S.D. 18.3) years were registered. Primary soft tissue injuries according to Tscherne's classification were noted in 22 patients (14.2%). Major perioperative soft tissue complications requiring revision occurred in five patients (3.2%). Minor perioperative soft tissue complications treated non-operatively occurred in 29 patients (18.8%). A significantly higher incidence of perioperative soft tissue complications occurred in alcohol abusers (P=0.043), after high-energy trauma (P=0.043), and after primary soft tissue injuries (P=0.004). Other possible risk factors such as age, gender, fracture type, diabetes, arteriosclerosis, coronary heart disease, and hypothyroidism had no statistically significant influence on the incidence of perioperative soft tissue complications.