{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T19:00:47Z","timestamp":1774119647382,"version":"3.50.1"},"reference-count":10,"publisher":"Royal College of Surgeons of England","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2006,7]]},"abstract":"<jats:sec><jats:title>INTRODUCTION<\/jats:title><jats:p> Ankle fractures are common and many require surgical intervention. It has been well documented that a delay in fracture fixation results in increased length of hospital stay and increased complication rate. Initial delay can also allow swelling or blistering to develop which may necessitate a further delay in operative fixation for up to 1 week. The aim of the current study was to review the length of hospital in-patient stay for operative ankle fractures over the previous 12-month period at our hospital and compare this to the length of hospital stay following the introduction of a fast-track system for the fixation of these fractures (all fractures fixed within 48 h). <\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS AND METHODS<\/jats:title><jats:p> A retrospective review of all ankle fractures managed by open reduction and internal fixation over a 12-month period was undertaken. A protocol was then agreed to openly reduce and fix these fractures at the earliest possible opportunity over the next 6-month period. We then collected the data on all ankle fractures that needed open reduction and internal fixation over this 6-month period. The pre-protocol and post-protocol groups were then compared for total hospital length of stay and complication rate. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> In the 12-month retrospective review, there were 83 ankle fractures that required surgical intervention. Sixty-two of these had surgery within 48 h (mean length of stay, 5.4 days), and 21 had surgery after 48 h (mean length of stay, 9.5 days). There were 39 ankle fractures in the post-protocol group who all had surgery within 48 h (mean length of stay, 5 days). There was no increase in complication rate after implementation of the fast-track system. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p> This study shows that early operative intervention for ankle fractures reduces the length of hospital stay. Intensive physiotherapy and co-ordinated discharge planning are also essential ingredients for early discharge. Early operative fixation for unstable ankle fractures has substantial cost-saving implications with no increase in complication rate. <\/jats:p><\/jats:sec>","DOI":"10.1308\/003588406x106504","type":"journal-article","created":{"date-parts":[[2006,7,7]],"date-time":"2006-07-07T01:58:20Z","timestamp":1152237500000},"page":"405-407","source":"Crossref","is-referenced-by-count":34,"title":["Cost Benefit with Early Operative Fixation of Unstable Ankle Fractures"],"prefix":"10.1308","volume":"88","author":[{"given":"P","family":"Pietzik","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, St Peter's Hospital Chertsey, Surrey, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, St Peter's Hospital Chertsey, Surrey, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Langdon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, St Peter's Hospital Chertsey, Surrey, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Molloy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, St Peter's Hospital Chertsey, Surrey, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Solan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, St Peter's Hospital Chertsey, Surrey, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"171","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199201000-00014"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1016\/0020-1383(88)90142-8"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.47B4.634"},{"key":"b4","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00003086-198702000-00027","volume":"215","author":"Fogel GR","year":"1987","journal-title":"Clin Orthop"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199505000-00003"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(00)00254-0"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.3109\/ort.1981.52.suppl-189.01"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.3109\/17453679809002356"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.3109\/17453679809002355"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200305000-00008"}],"container-title":["The Annals of The Royal College of Surgeons of England"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/pdf\/10.1308\/003588406X106504","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T10:10:01Z","timestamp":1684145401000},"score":1,"resource":{"primary":{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/10.1308\/003588406X106504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,7]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2006,7]]}},"alternative-id":["10.1308\/003588406X106504"],"URL":"https:\/\/doi.org\/10.1308\/003588406x106504","relation":{},"ISSN":["0035-8843","1478-7083"],"issn-type":[{"value":"0035-8843","type":"print"},{"value":"1478-7083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,7]]}}}