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Healthcare Utilization and Recovery Duration After Ankle Fracture: A Claims-Based Study of Timeline, Costs and Complications

J Eval Clin Pract. 2026 Jun;32(4):e70450. doi: 10.1111/jep.70450.

ABSTRACT

RATIONALE: Ankle fractures are common orthopaedic injuries with wide variability in recovery duration and outcome. While long-term outcomes are well documented, less is known about the short-term recovery period. An updated analysis using claims data would provide greater clarity on short-term recovery patterns.

AIMS AND OBJECTIVES: The study aimed to characterise recovery duration after treatment for ankle fracture and to evaluate associations between comorbidities, perioperative complications, additional procedures and healthcare costs.

METHOD: Healthcare claims from the IBM MarketScan database (2015-2018) were analysed to determine recovery costs for the index treatment and subsequent events including revision surgery, motion restoring surgery (MRS), rehospitalizations, and complication-related interventions. Recovery duration was defined as the interval between the initial surgery/treatment and the final physical/occupational therapy claim. Outcomes were summarised using medians and interquartile ranges (IQR).

RESULTS: Among 7,112 patients, the median index treatment cost was $5163 (IQR: $994-$12,444), and the recovery duration was 88 days (IQR: 36-492). Thirty-eight percent of patients required more than 6 months to complete recovery. Post-treatment complications were associated with markedly longer and more expensive recovery. Patients who required a complication-related surgery had a recovery duration that was 4 times longer and incurred costs that were 8 times greater than those without such events. Joint contracture and MRS were strongly associated with prolonged and costly recoveries.

CONCLUSION: This claims‑based analysis identified wide variation in short‑term recovery after ankle fracture. Strong associations were demonstrated between complications, including joint contracture, MRS and rehospitalizations, and extended recovery duration and higher costs. These findings may help clinicians identify patients at risk for delayed recovery and support more informed decision‑making in early post‑treatment care.

PMID:42070271 | DOI:10.1111/jep.70450

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