Postoperative Treatment of Internally Fixed Ankle Fractures

Abstract

In a prospective, randomised trial of 81 patients with fractures of the ankle of AO types A, B and C we compared two regimes of postoperative management after internal fixation. The patients were mobilised either non-weight-bearing with crutches or weight-bearing in a below-knee walking plaster. We found a temporary benefit in subjective evaluation only (65 v 50 points, Mann-Whitney test, cft, p = 0.02) for those with a below-knee walking plaster. There were no significant differences between the groups in the loaded dorsal range of movement (25° v 23°, Mann-Whitney test, cft, p = 0.16) or in the overall clinical result. Both treatments were considered to be satisfactory and their choice depends on the ability to mobilise non-weight-bearing, wound healing, the type of work and personal preference.

Outcome of Surgical Management of Bimalleolar Fractures in Adults

“…We followed this system to classify the ankle trauma. The most common type of injury was SER (46.6%), followed by pronation-abduction injury (33.3%), and our observation is in accordance with previous reports [12,16,20,22,23] Weber classification that considers integrity of syndesmosis, classifies the ankle fracture into three Groups-A, B, C. In our patients, AO Type B was the most common (66.6%) and least in Type A (6.6%). Motwani et al too report a similar observation [18,22,24].…”

Evaluation of Management of Malleolar Fractures of Ankle Joint

“…The high incidence of supination-external rotation injuries is common in present series as in series of Van Laarhoven, 14 Egol 16 . Generally, these fractures account for about 60 per cent of all ankle fracture .AO type B fractures were common in present series as in Makwaana 11 et al, Van Laarhoven 14 et al series.…”

The dynamic vacuum orthosis: a functional and economical benefit?

“…All ankle fractures healed well with comparably good radiological and clinical outcomes by the time of the ten-week follow-up. Advantages of early full weight bearing for ankle mobility are a topics of controversial debate [6,24]. Isolated reports of negative consequences for fracture healing following early full weight bearing [5] conflict with studies that show that a certain amount of mechanical stimulation promotes fracture healing [9,10].…”

“…One deserving special mention is the functional outcome that, influenced by pain and oedema, makes a fundamental contribution to the restoration of the patient's level of activity before the accident and, thus, to quality of life. In addition to other factors such as fracture pattern, soft tissue injury and surgical procedure, the methods of rehabilitation are also important with regard to patient satisfaction and functional outcome [7,24]. Early mobilisation can prevent the negative consequences of joint immobilisation [4] such as muscle atrophy [12], thrombosis [11] and cartilaginous damage [21].…”

“…The results are not entirely uniform. Some researchers have found no difference [24]; others report a better functional outcome for functional rehabilitation as seen predominantly in the early postoperative phase (up to ten weeks), which then equates over time with outcomes for cast immobilisation [8,22]. However, early functional rehabilitation will generally not include an early increase in weight bearing, even though this might result in more rapid consolidation of the fracture [3,15].…”