We reviewed thirty-eight cases of open ankle fractures that had been
treated with a standard protocol: alignment and splinting of the fracture
at the scene of injury if possible, antibiotics administered in the
emergency room and continued for forty-eight hours, admission of the
patient to the operating room as quickly as possible, copious irrigation
and thorough debridement of the wound, immediate rigid anatomical internal
fixation, and delayed primary closure at five days. All of the fractures
united, but three patients required subsequent ankle fusion because of
cartilage damage noted at the initial operation. Of the thirty-five ankles
with complete follow-up, the functional result was excellent in twenty-six
and fair or poor in nine.