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Abstract

Background: Ankle fractures, particularly Weber B and C types, present challenges requiring surgical intervention due to their instability. Early and Swift reduction is pivotal, minimizing pain, swelling, and neurovascular issues and facilitating better soft tissue healing. Our orthopedic department employs various closed reduction techniques, and post-reduction, two methods are applied: casting with a plaster U-splint which allows the patient to be more mobile until surgery, and stockinette suspension, which potentially allows for early intervention. However, a comparative analysis of these techniques needs to be improved. Hence, we compare the two methods to assess their effects on soft tissue healing, surgery timing, pain control, and rehabilitation.

Methods: This observational, retrospective study, spanning 2019 to 2021, examines 54 patient files with Weber B or C ankle fractures. Inclusion criteria involve patients aged 18 to 65 with no significant prior ankle injuries or medical conditions affecting lower limb healing. The dependent variable is the time from fracture to surgery, while independent variables include pre-surgical treatment technique, background diseases, pre-fracture functional status, and inflammation indices. Statistical analyses include descriptive measures, Pearson correlation tests, and SPSS-28 software for significance. The Bnai-Zion Medical Center's Helsinki committee approved the study ethically.

Results: 54 patients met the inclusion criteria and were divided into two groups according to the pre-surgical treatment method, i.e., casting with plaster U-splint vs. stockinette suspension (Quigley's technique). The time between the fracture and the definitive surgery was shorter in the stockinette suspension group compared to the casting group.

Conclusions: Our data suggests that Quigley's technique surpasses casting with U-splint plaster in reducing the time between an ankle fracture and definitive surgery. This finding emphasizes the potential advantages of adopting Quigley's technique in managing Weber B and C ankle fractures, promoting swifter interventions, and potentially enhancing overall patient outcomes.