BACKGROUND: Rotational injuries are the most common and usually classified as per the Lauge Hansen classification; with the most common subgroup being the supination external rotation (SER) mechanism. Isolated @entity174 of the distal fibula ( @entity11632 ) without associated @entity130 are usually treated with a splint or brace and the @entity1 may be allowed to weight bear as tolerated. This study reports the functional outcomes following a stable, low energy, rotational @entity1171 supination external rotation ( @entity13060 ) when compared to unstable SER4 @entity174 treated operatively. MATERIALS AND METHODS: 64 @entity1 who were diagnosed and treated nonoperatively for a stable @entity13060 @entity1171 were followed prospectively. In the comparison group, 93 operatively treated fibular @entity174 were extracted from a prospectively collected database and evaluated comparison. Baseline characteristics obtained by trained interviewers at the time of injury included: @entity1 demographics, short form-36, short musculoskeletal functional assessment (SMFA) and American Orthopedic Foot and Ankle Society (AOFAS) questionnaires. @entity1 were followed at 3, 6 and 12 months postsurgery. Additional information obtained at each followup point included any complications or evidence on @entity174 healing. Data were analyzed by the Student's t-test and theFisher's Exact Test to compare demographic and functional outcomes between the two cohorts. P < 0.05 was considered to be significant. RESULTS: The average of @entity1 ' age in the stable @entity174 cohort was 43 versus 45 in the SER4 group. Nearly 64% of the @entity1 population was female when compared with 37% in the operative group. In the @entity13060 by 6 months all @entity1 had returned to baseline functional status. There were 18 delayed unions (all healed by 6 months). Based on the functional outcome scores all @entity1 had returned to preoperative level. In comparison, SE4 @entity1 had less functional recovery at 3 and 6 months (P < 0.05) based on the SMFA scores and at 3, 6 and 12 months based on the AOFAS (P < 0.001) scores. There was no difference in pain levels between the two groups at all time points. There were three nonunions in the SE4 group and six delayed unions. CONCLUSIONS: An @entity13060 @entity1171 is a relatively benign @entity99 resolving by 3 months while the need for surgical fixation in SER @entity1171 appears to affect lower extremity function to a greater degree for a longer time period. @entity1 should be counseled as to these expected outcomes.

Supination external rotation XXXX : A simpler pattern with better outcomes.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'Patient'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'fracture'] @entity13060 :: ('3714', 'Gene') :: ['SER2'] @entity1171 :: ('MESH:D064386', 'Disease') :: ['ankle fracture', 'ankle fractures'] @entity11632 :: ('2524', 'Gene') :: ['SE2'] @entity99 :: ('MESH:D056486', 'Disease') :: ['injury with functional limitations'] @entity130 :: ('MESH:D014947', 'Disease') :: ['ligamentous injury']
@entity1171 :: (MESH:D064386,Disease) :: ['ankle fractures']
