BACKGROUND: The aim of operative treatment for ankle fractures is to allow early movement after internal fixation. The hypothesis of this study was that early mobilization would improve functional recovery in patients after surgery for ankle fractures. METHODS: In a prospective randomized controlled study, 66 consecutive patients with ankle fractures that required open reduction and internal fixation (ORIF) were assigned to one of two postoperative regimens: immobilization in a nonweightbearing below-knee cast or early mobilization in a removable cast. Four patients were excluded from the study, leaving 62 for review. RESULTS: Patients who had early mobilization in a removable cast had higher functional scores (Olerud-Molander and AOFAS) at 9 and 12 weeks postoperatively. They also returned to work earlier (67 days) compared with those treated in nonweightbearing below-knee cast (95 days), p<0.05. There was no statistical difference in Quality of Life (SF-36 Questionnaire) at 6 months between the two groups. We had an approximately 10% postoperative infection trend (one superficial and two deep) in the early mobilization group. CONCLUSION: Despite the overall short-term benefit of early mobilization, we had three patients in the early mobilization group who had wound complications. Both the surgeon and patient should be aware of the higher risk of wound complications associated with this treatment, and thus the accelerated rehabilitation protocol should be individualized.
RCT Entities:
BACKGROUND: The aim of operative treatment for ankle fractures is to allow early movement after internal fixation. The hypothesis of this study was that early mobilization would improve functional recovery in patients after surgery for ankle fractures. METHODS: In a prospective randomized controlled study, 66 consecutive patients with ankle fractures that required open reduction and internal fixation (ORIF) were assigned to one of two postoperative regimens: immobilization in a nonweightbearing below-knee cast or early mobilization in a removable cast. Four patients were excluded from the study, leaving 62 for review. RESULTS:Patients who had early mobilization in a removable cast had higher functional scores (Olerud-Molander and AOFAS) at 9 and 12 weeks postoperatively. They also returned to work earlier (67 days) compared with those treated in nonweightbearing below-knee cast (95 days), p<0.05. There was no statistical difference in Quality of Life (SF-36 Questionnaire) at 6 months between the two groups. We had an approximately 10% postoperative infection trend (one superficial and two deep) in the early mobilization group. CONCLUSION: Despite the overall short-term benefit of early mobilization, we had three patients in the early mobilization group who had wound complications. Both the surgeon and patient should be aware of the higher risk of wound complications associated with this treatment, and thus the accelerated rehabilitation protocol should be individualized.
Authors: Brandyn D Lau; Patrick Murphy; Anthony J Nastasi; Stella Seal; Peggy S Kraus; Deborah B Hobson; Dauryne L Shaffer; Christine G Holzmueller; Jonathan K Aboagye; Michael B Streiff; Elliott R Haut Journal: CMAJ Open Date: 2020-12-08
Authors: Jan Paul Briet; Roderick M Houwert; Diederik P J Smeeing; Janity S Pawiroredjo; Johannes C Kelder; Koen W Lansink; Luke P H Leenen; Peer van der Zwaal; Stephan W A M van Zutphen; Jochem M Hoogendoorn; Mark van Heijl; Egbert J M M Verleisdonk; Guus W van Lammeren; Michiel J Segers; Falco Hietbrink Journal: Trials Date: 2015-04-18 Impact factor: 2.279
Authors: Diederik P J Smeeing; Roderick M Houwert; Jan Paul Briet; Johannes C Kelder; Michiel J M Segers; Egbert Jan M M Verleisdonk; Luke P H Leenen; Falco Hietbrink Journal: PLoS One Date: 2015-02-19 Impact factor: 3.240
Authors: D P J Smeeing; R M Houwert; M C Kruyt; O A J van der Meijden; F Hietbrink Journal: Eur J Trauma Emerg Surg Date: 2016-09-01 Impact factor: 3.693