Only 1 in 4 athletes return to full sports after ankle fracture surgery
By Mary Ann Porucznik
A year after being operatively treated for ankle fractures, only about one in four athletes had returned to full sporting activity, according to the results of a study presented in poster exhibit P449.
Younger patients were more likely to return to sports than older patients; males more likely to return to sports than females, and patients with an American Society of Anesthesiologists Classification (ASA) of one or two were 10 times more likely to return to sport than those with an ASA of three or four.
This prospective study followed 194 patients (56.6 percent males, 43.4 percent females), who preoperatively identified themselves as participating in sports at any level. All patients were treated surgically by one of four fellowship trained trauma surgeons at a tertiary care center for an unstable ankle fracture. Follow-up for all patients was similar.
Postoperative patient demographics were examined to determine if there was a relationship with return to baseline sports. Three months after surgery, only 3 percent of all patients had returned to full sports. At six months postoperative, 14 percent of patients had returned to full sports, while at one year, only 24 percent of patients had returned to full sporting activity.
At every time point, researchers found that younger age was predictive of return to sports (at 3 months, p = 0.04; at 6 months, p = 0.026, and at 12 months, p = 0.0001). Males were more likely to return to sports at 6 months (p = 0.04) and 12 months (p = 0.026).
In addition, researchers found that the degree of injury also had an effect on return to sports. At 12 months postoperative, patients who had unimalleolar injuries were more likely to return to sports than those with bimalleolar ankle fractures (p = 0.018). A patient with an ASA of one or two was 10 times more likely to return to sports than a patient with an ASA of three or four (p = 0.01) at three months.
The lead investigator for the study is Alexis Chiang, MD, of New York City. Additional researchers include: Michael Walsh, PhD; Toni M. McLaurin, MD; Nirmal C. Tejwani, MD; and Kenneth A. Egol, MD, all of New York City; and Kenneth J. Koval, MD, of Lebanon, N.H. Dr. Koval is a consultant for EBI and Stryker Howmedica; Dr. Tejwani has received research support from EBI, Stryker Howmedica and Zimmer.