Friedman, Lisa G.M.Sanchez, DanielaZachos, Terri A.Marcantonio, AndrewAudet, MeganVallier, HeatherMullis, BrianMyers-White, AdamKempton, LaurenceWatts, JeffreyHorwitz, Daniel S.2022-10-202022-10-202021-05-11Friedman LGM, Sanchez D, Zachos TA, et al. Potential Benefits of Limited Clinical and Radiographic Follow-up After Surgical Treatment of Ankle Fractures. J Am Acad Orthop Surg Glob Res Rev. 2021;5(5):e21.00074. Published 2021 May 11. doi:10.5435/JAAOSGlobal-D-21-00074https://hdl.handle.net/1805/30378Introduction: Ankle fractures are one of the most prevalent musculoskeletal injuries, with a significant number requiring surgical treatment. Postoperative complications requiring additional interventions frequently occur during the early postoperative period. We hypothesize that there is a limited need for routine clinical and radiographic follow-up once the fracture is deemed healed. Methods: IRB approval was obtained at four academic trauma centers. A retrospective chart review was done to identify adults with healed unimalleolar and bimalleolar ankle fractures treated surgically with at least 12 months of follow-up. Based on postoperative radiographs, changes in fracture alignment and implant position from radiographic union to final follow-up were documented. The average reimbursement for a final follow-up clinic visit and a set of ankle radiographs were estimated. Results: A total of 140 patients met inclusion criteria. The mean age at injury was 49.5 years, and 67.9% of patients were female. The mean time to healing was 82.2 days (±33.5 days). After radiographic healing, one patient had radiographic changes but was asymptomatic and full weight bearing at their final follow-up. On average, our institution was reimbursed $46 to $49 for a follow-up clinic visit and $364 to $497 for a set of ankle radiographs. Conclusion: Given the average time to healing, there is limited utility in routine radiographic and clinical follow-up beyond 16 weeks in asymptomatic patients. In our series, this would result in a savings of $950 to $1,200 per patient. However, after ankle fractures were deemed healed, 0.7% patients had radiographic evidence of a change in implant position. Documenting this change did not modify the immediate course of fracture treatment. Surgeons will need to balance the need for routine follow-up with the potential economic benefits in reducing costs to the healthcare system.en-USAttribution 4.0 InternationalAnkle fracturesInternal fracture fixationFracture healingArticle