Audit of SWFT Ankle Fracture Management Compared to BOAST Guidelines

Abstract

Aim: In 2016 the BOA introduced an Audit Standard for Trauma (BOAST) for the management of ankle fractures. Our aim was to conduct an audit of SWFT compliance with the 2016 BOAST guidelines. Method: We conducted a retrospective analysis of 49 patients who attended SWFT in 2018-2019. Their admission X-Ray views, neurovascular status & co-morbidity documentation, time to theatre and weight bearing status post operatively were reviewed. We also reviewed the outcomes of follow up to determine whether a change in WB status was implemented. Result: 82% patients had their neurovascular status documented, 94% had their co-morbidities documented and 67% had correct imaging performed. 2 patients were initially treated conservatively, the average time to theatre for the remainder was 3 days. None of the patients were FWB post op - 6% could touch WB and 94% were NWB. On follow up, 78% patients remained NWB for 6 weeks, 9 were allowed to WB sooner & 2 patients were repatriated post op. Conclusion: The Orthopaedic department at SWFT is maintaining a correlation with BOAST 2016 ankle fracture guidelines in certain aspects such as NV status and co-morbidities. However, we are not adhering to guidelines regarding WB status of patients post-operatively.