Compared to conventional physiotherapy, does the use of an ankle trainer device after Weber B ankle fracture operation improve outcome and shorten hospital stay? A randomized controlled trial

Abstract

Objective: To compare the functional outcomes and length of hospital stay for patients treated with conventional physiotherapy compared to a new ankle trainer device after Weber B ankle fractures. Design: The patients were randomized, and then followed up at 3, 6, 12 and 52 weeks by a blinded physiotherapist. Setting: This study was done at a level 1 trauma centre. Subjects: One hundred and forty consecutive patients with Weber B ankle fractures that were operated on were screened for eligibility, of whom 113 were included in the study. Interventions: Conventional physiotherapy with stretching exercises, using a non-elastic band or using new ankle trainer. Main measures: Outcomes were evaluated with Olerud–Molander ankle score, Visual analogue scale for pain and ankle dorsiflexion at 3, 6, 12 and 52 weeks follow-up. Time of hospitalization and complications were registered. Results: Superior Olerud–Molander ankle scores were observed at three weeks follow-up in the ankle trainer group 40.9 (10.8), compared to the conventional group 35.3 (14.2) ( P = 0.021). At one-year follow-up, there was no difference between the groups ( P = 0.386). The ankle trainer group had a shorter hospital stay with a mean 2.6 days (0.98) compared to 3.2 days (1.47) in the conventional group ( P = 0.026). Conclusion: The patients who were treated with the new ankle trainer device recovered more rapidly, evaluated by the Olerud–Molander ankle score and had a shorter stay in hospital compared to the conventional physiotherapy group. No between group differences could be observed at long-term follow-up.

Characteristics and Effectiveness of Postoperative Rehabilitation Strategies in Ankle Fractures: A Systematic Review

“…Of all studies, 40 23–61 described their postoperative rehabilitation strategy but did not evaluate effectiveness and 15 20–22,62–73 focused on evaluating the effectiveness of the postoperative rehabilitation strategy. This section reports only those 40 studies that described their postoperative rehabilitation strategy, focusing on weight-bearing, immobilization, and other therapy administered.…”

“…There were no statistically significant differences between groups. Molund et al, 2020 73 practice. Weight-bearing and the timing of weight-bearing postoperatively seems to be an important factor, with early weight-bearing potentially improving short-term outcomes without appearing to compromise long-term outcomes.…”