Early weight bearing compared with non-weight bearing functional mobilization after operative treatment of an ankle fracture

Abstract

Ankle fractures are the most common types of fractures treated in orthopaedics. When to begin ankle movement and weight bearing and the type of immobilizing devices to use post-operatively have had more intense clinical study than most other aspects of ankle fracture treatment. Aim of this study is to compare the results of two functional methods of post-operative treatment in internally fixed ankle fractures, i.e. one after early weight bearing using walking plaster and the other after non-weight bearing functional mobilization in the first six weeks following stable internal fixation. This is a prospective, non-randomized study. Between March 2004 and February 2006, thirty- five patients with displaced ankle fractures treated by internal fixation were assigned in a way that every alternate patient fell in different groups. Group A patients, 17, were managed with a below-knee walking plaster and group B patients, 18 with non-weight bearing mobilization with crutches. Five patients were lost in follow up and 30 were followed regularly as in the protocol. There was a temporary benefit in subjective evaluation (63 v 48 points, student t test. P=0.262), return to work (53.8 v 72.9 days, student t test, p=0.079) for those with a below-knee walking plaster at six week. There were minimal differences between the groups in the loss of dorsal range of movement (14.7 v 13.1 degree) or in the overall clinical results at the first follow up. But the differences disappeared in any evaluation after three months. Both treatments were considered to be satisfactory and the treatment choice depends on the ability to mobilize or weight bearing, the type of work and personal preference.

DOI: http://dx.doi.org/10.3126/jcmsn.v7i1.5972

JCMSN 2011; 7(1): 40-46