785 Ankle Fractures Management in Stoke Mandeville Hospital

Introduction Ankle fractures treatment aims to restore joint stability and alignment to achieve full functional recovery. Current quality of care in Stoke Mandeville Hospital was compared to the gold-standard management approach as described in BOAST-12 guidelines. Method This closed loop audit looked at closed malleolar and syndesmotic ankle injuries in skeletally mature patients under Trauma and Orthopaedics. In the first audit cycle, 16 patients were included over a one-month period and 53 cases, with similar management, were identified over a three-month period for the second audit cycle. Results The initial audit cycle revealed that the main aspects of management that required improvement were the timing of reduction and splinting, as well as the documentation of neurovascular status post-reduction. We discussed our findings at the clinical governance meeting and interventional posters were distributed around the hospital. Documentation of the timing of reduction and splinting significantly increased from 6% to 85% post-interventions, and neurovascular examination post-reduction improved from 17% to 43%. All other quality assessment criteria recorded more than 90% documentation rates after implementation of changes. Conclusions Quality of care significantly improved post-interventions, which indicates that BOAST-12 gold-standard is achievable. The introduction of a proforma was suggested to further facilitate appropriate documentation.