Rotational ankle fractures are among the most prevalent intra-articular fractures of the body. When managed appropriately, they have favorable outcomes with relatively low complication rates. The proper management of these injuries requires an understanding of the radiographic imaging, surgical anatomy, and biomechanics of both the tibiotalar and distal tibiofibular joint. Some of the most common and impactful complications of operatively treated ankle fractures include wound necrosis, surgical site infection, malunion, nonunion, and posttraumatic ankle arthritis. The management of these complications must be assessed on an individual case basis, but often requires a thorough preoperative evaluation and meticulous surgical planning to insure a successful outcome. This chapter provides a review of the management of subacute and malreduced ankle fractures as well as a brief review of the rates, risk factors, and management of other common complications associated with ankle fractures.
Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.