Gait asymmetry following successful surgical treatment of ankle fractures in young adults.

Forty patients (mean age, 22.8 years) admitted for displaced ankle fracture were observed retrospectively to determine by clinical examination and measurement of plantar pressure distribution whether successful surgical treatment of ankle fractures led to gait symmetry, and whether intraindividual differences were related to fracture type and clinical outcome. The mean followup was 18.5 months (range, 12-36 months). The deviation of gait was quantified using a symmetry index of the total impulse. Using a clinical score, 6 patients had unsatisfactory results, and the remaining 34 had satisfactory results. The symmetry index of the good (-1.1%) and the poor results (-2.3%) decreased in the range of a healthy control group (-0.31%, n = 90), indicating that overall gait symmetry was achieved after trauma. The plantar pressure distribution showed significant load asymmetries. There was increased loading in the lateral forefoot of the injured leg in patients with good results and decreased pressure under the metatarsal heads of patients with bad results. Although those asymmetries were related neither to fracture type nor clinical outcome, the findings may illustrate compensation mechanisms that are used to regain gait symmetry after ankle alteration by trauma.