Functional outcome after surgical treatment of ankle fracture using Baird Jackson score


  • Amlan Mohapatra Department of Orthopedics, AJ Institute of Medical Sciences, Mangalore, Karnataka
  • Karthik Raj Department of Orthopedics, AJ Institute of Medical Sciences, Mangalore, Karnataka



Ankle fracture, Outcome, Malleolar fracture


Background: Ankle fractures have been identified as a significant source of morbidity for both the young and the elderly. In this study we aim to evaluate the functional outcome of patients who were operated for ankle fracture at our centre and to assess the factors associated with the functional outcome.

Methods: An observational study in the Department of Orthopedics, AJ Institute of Medical Sciences, Mangalore, Karnataka from January 1, 2017 till December 31, 2017 of all patients who presented with any type of ankle malleolar fracture and underwent surgery were included in the study. Clinical history, socio-demographic profile, anatomic classification and Weber’s classification was noted for all patients. Functional outcome was evaluated 6 months post-operatively using the Baird Jackson scale and factors associated were assessed.

Results: During the study period 84 patients were enrolled in the study, mean age was 43.8±5.46 years and 48 were male patients. Supination external rotation was the most commonly seen injury in our patient population. Postoperatively, superficial skin infections were seen in 15% and restricted ankle movement in 11% patients. According to the Baird and Jackson score, clinical functional outcome was excellent in 17 cases, good in 47, fair in 15 and poor in 5 patients. Patients aged less than 45 years and supination external rotation injuries were significantly associated with excellent and good functional outcomes as compared to patients of older age.

Conclusions: Surgical treatment resulted in excellent to good functional outcome in majority of the patients of this study. Further research is required to assess the clinical and functional outcomes in patients with long term follow up. 


Guggenbuhl P, Meadeb J, Chalès G. Osteoporotic fractures of the proximal humerus, pelvis, and ankle: epidemiology and diagnosis. Joint Bone Spine. 2005;72(5):372-5.

Hasselman CT, Vogt MT, Stone KL, Cauley JA, Conti SF. Foot and ankle fractures in elderly white women: incidence and risk factors. JBJS. 2003;85(5):820-4.

Makwana NK, Bhowal B, Harper WM, Hui AW. Conservative versus operative treatment for displaced ankle fractures in patients over 55 years of age: a prospective, randomised study. Bone & Joint J. 2001;83(4):525-9.

Vioreanu M, Brophy S, Dudeney S, Hurson B, Kelly E, O’Rourke K, et al. Displaced ankle fractures in the geriatric population: operative or non-operative treatment. Foot Ankle Surg. 2007;13(1):10-4.

Koval KJ, Zhou W, Sparks MJ, Cantu RV, Hecht P, Lurie J. Complications after ankle fracture in elderly patients. Foot Ankle Int. 2007;28(12):1249-55.

Baird RA, Jackson ST. Fractures of the distal part of the fibula with associated disruption of the deltoid ligament. Treatment without repair of the deltoid ligament. J Bone Joint Surg Am. 1987;69(9):1346-52.

LindsjÖ U. Classification of ankle fractures: the Lauge-Hansen or AO system? Clinical Orthop Related Res. 1985;199:12-6.

Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37:691–7.

Herscovici Jr D, Scaduto JM, Infante A. Conservative treatment of isolated fractures of the medial malleolus. J Bone Jt Surg. 2007;89:89-93.

Shah NH, Sundaram RO, Velusamy A, Braithwaite IJ. Five-year functional outcome analysis of ankle fracture fixation. Injury. 2007;38:1308-12.

Tejwani NC, McLaurin TM, Walsh M, Bhadsavle S, Koval KJ, Egol KA. Are outcomes of bimalleolar fractures poorer than those of lateral malleolar fractures with medial ligamentous injury? J Bone Joint Surg Am. 2007;89:1438-41.

Schepers T, De Vries MR, Van Lieshout EM, Van der Elst M. The timing of ankle fracture surgery and the effect on infectious complications; a case series and systematic review of the literature. Int Orthop. 2013;37(3):489-94.

Schepers T, Van Lieshout EM, De Vries MR, Van der Elst M. Increased rates of wound complications with locking plates in distal fibular fractures. Injury. 2011;42(10):1125-9.

Appleton P, McQueen M. The fibula nail for treatment of ankle fractures in elderly and high risk patients. Techniques Foot Ankle Surg. 2006;5(3):204-8.

Büchler L, Tannast M, Bonel HM, Weber M. Reliability of radiologic assessment of the fracture anatomy at the posterior tibial plafond in malleolar fractures. J Orthop Trauma. 2009;23(3):208-12.

Obremskey WT, Dirschl DR, Crowther JD, Craig WL III, Driver RE, LeCroy CM. Change over time of SF-36 functional outcomes for operatively treated unstable ankle fractures. J Orthop Trauma. 2002;16:30-3.






Original Research Articles