Treatment of open ankle fractures. Immediate internal fixation versus closed immobilization and delayed fixation.

Thirty-one open ankle fractures were treated over a period of 11 years and retrospectively reviewed with an average follow-up period of 61 months. Fifteen were managed by closed immobilization and delayed internal fixation. Sixteen were treated with immediate open reduction and internal fixation. One case in each group became infected. Functional scores at follow-up examination were the same for both groups. The fractures treated with immediate open reduction and internal fixation showed less impairment of range of motion but had a greater incidence of chronic ankle swelling. The hospitalization time was significantly shorter for the patients treated by open reduction and internal fixation. Immediate open reduction and internal fixation of open ankle fractures speed recovery with no greater incidence of infection than encountered with conservative treatment.