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Abstract Given the lack of evidence-based literature,it is not possible to definitively recommend the use of ARIF or arthroscopy-assisted ORIF for the management of ankle fracture. However,there seems to be general agreement agreement regarding the high incidence of intra-articular pathology associated with ankle fracture. In ankle fractures managed with ORIF, some of these conditions may be missed, resulting in chronic complaints. The main advantages of ARIF include limited exposure, preservation of blood supply, and improved visualization of the pathology. However, ARIF requires increased surgical time, is technically more challenging than ORIF, and may result in softtissue swelling. Although ARIF may cost more initially, it may result in reduced long-term costs associated with chronic conditions. Currently, arthroscopy is indicated for management of talar dome fractures and fractures associated with small loose fragments within the joint. Arthroscopy is also indicated for the evaluation and management of syndesmotic injury and persistent pain following definitive management of ankle fractures. Although the use of arthroscopy in trauma is increasing, the effectiveness of ARIF compared with ORIF in the management of fractures of the distal tibia,malleollus, displaced talar neck, and talar body has yet to be determined. Thus, most of these fractures can still be managed with open procedures. |