Prognosis

In order to be able to make a statement on the prognosis of a trimalleolar ankle fracture, it is important to include factors such as the age of the patient, the complexity of the fracture, and also the patient’s cooperation and commitment in the follow-up treatment in the evaluation. In general, the prognosis is better the less of the articular surface of the upper ankle is destroyed and the better the bone portions are reduced. The postoperative rehabilitation measure is decisive for the mobility and flexibility as well as the resilience of the joint.

Since the joint tends to become stiffer and immobile after the operation, exercises for mobilization and also for improving coordination are important in order to avoid impairments in everyday life and sports. Realistically, the regeneration phase after a trimalleolar ankle injury can last up to a year and it is within the realm of possibility that the function and load-bearing capacity of the joint cannot be fully restored. Furthermore, a trimalleolar ankle fracture is a predisposition for various secondary diseases of the joint, such as the formation of a false joint (pseudarthrosis) or for the development of arthrosis.

Late effects

A trimalleolar ankle fracture can lead to the development of various secondary diseases and late effects, since the fracture has usually had a severe traumatic impact on the joint. If the joint surfaces are no longer optimally aligned, if there are step formations in the joint or if the joint cartilage has been injured, the occurrence of late consequences is very likely. Ankle problems after surgery are usually manifested by recurrent swelling of the joint under stress, pain and restricted movement or instability.

These symptoms should recede at the latest 6 months postoperatively, otherwise a doctor should examine the ankle again in order to be able to alleviate late effects. One of the most common late effects after a trimalleolar ankle fracture is arthrosis, i.e. the progressive wear and tear of the joint cartilage, which can cause pain, swelling and movement restrictions and is no longer reversible. In addition, pseudoarthrosis is possible, in which healing of the bone has been incomplete and which affects the stability of the ankle joint. This can lead to increased buckling and thus to further damage to the joint. More information under: Physiotherapy Ankle Joint Arthrosis