Time Frame to Surgery from Presentation of Ankle Fractures and the Impact of the BOAST Standards, do we meet the BOAST Guidelines?

Abstract

Purpose: The aim of this study was to evaluate the compliance with the BOAST guidelines for early fixation on the day or day after ankle fractures in the age group of 60 years old or less when the ankle mortise is unstable. Method: This retrospective study reviewed all the ankle fractures that were admitted for ankle fixation in 2015-2016, pre BOAST standard, and following it in 2018- 2019. The inclusion and exclusion criteria used in the standard were then applied. Results: In 2018-19, 44 patients fulfilled the inclusion criteria, 18 males with an average age of 39.3 and 26 females with an average age of 42.2. Twenty-nine ankles (66%) were fixed on the day or day after injury while 5 ankles (11%) had the surgery within 48 hours. In 2015-16, 37 patients fulfilled our inclusion criteria, 21 males with an average age of 37.8 years, 16 females with an average age of 42.1 years. Twenty-one ankles (56.7%) were fixed on the day or day after injury. While 8 ankles (21.6%) had the surgery within 48 hours. Conclusion: Most of the ankle fractures requiring surgery, who presented to our trust, were fixed within 48 hours accounting for 77% of cases in 2018-19 versus 79% in 2015-16 with no statistically significant difference in our practice between pre and post BOAST guidelines publishing. The rest of cases had delayed fixation mainly due to the surrounding soft tissue swelling.