Comparison of Early Versus Delayed Weight-bearing Outcomes after Ankle Fractures Surgical Treatment; A Retrospective Analytical Study Rehabilitation after Ankle Fracture
Journal of Clinical Physiotherapy Research,
Vol. 6 No. 4 (2021),
1 Mehr 2021
,
Page e50
https://doi.org/10.22037/jcpr.v6i4.35532
Abstract
Introduction: This study aimed to evaluate the early and delayed weight-bearing outcomes in patients with ankle fractures who underwent surgical treatment. Materials and Methods: This retrospective analytical study was conducted on 38 patients with bimalleolar ortrimalleolar fractures referred to Taleghani Hospital, Tehran, Iran. Patients who underwent ankle fracture surgical treatment were divided into the early weight-bearing group (study group) and the delayed weight-bearing group (comparison group). The outcomes were functional factors including pain, bulging, running, support, daycare, and stiffness were assessed and compared between the groups. Data were analyzed by IBM SPSS Statistics ver.23 at significant level of P-values <0.05. The Kolmogorov-Smirnov test approved the normality of data. Chi-squared test and independent T-Test were used to compare the outcomes between the groups. Results: Out of 38 patients, 30 were men (79%), and 8 were female (21%), with a mean age of 32.12 ±1.22 years old (range: 17 to 58 years). Contrary to the comparison group (delayed weight-bearing), pain (P=0.006), running (P=0.035), support (P=0.003), daycare (P=0.001), and total scores (P=0.001) were significantly higher in the intervention group (early weight-bearing) two weeks after the surgery. The other variables (bulging, stiffness, staring up, jumping, sitting/standing) did not significantly differ between the groups (P>0.05). Conclusions: Based on the results, early weight-bearing compared to delayed weight-bearing, has better outcomes in patients with ankle fractures who underwent surgical management.
- Ankle fracture; Rehabilitation; Weight-bearing
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References
2. Rose A, Lee RJ, Williams RM, Thomson LC, Forsyth A: Functional instability in non-contact ankle ligament injuries. Br J Sports Med 2000, 34:352-358.
3. Egol KA, Dolan R, Koval KJ: Functional outcome of surgery for fractures of the ankle. A prospective, randomised comparison of management in a cast or a functional brace. J Bone Joint Surg Br 2000, 82:246-249.
4. Minator Sajjadi M, Ebrahimpour A, Okhovatpour MA, Karimi A, Zandi R, Sharifzadeh A. The Outcomes of Pilon Fracture Treatment: Primary Open Reduction and Internal Fixation Versus Two-stage Approach. Arch Bone Jt Surg. 2018; 6(5): 412-419.
5. Risberg MA, Holm I, Myklebust G, Engebretsen L: Neuromuscular training versus strength training during first 6 months after anterior cruciate ligament reconstruction: a randomized clinical trial. Phys Ther 2007, 87:737-750.
6. Ageberg E: Consequences of a ligament injury on neuromuscular function and relevance to rehabilitation - using the anterior cruciate ligament-injured knee as model. J Electromyogr Kinesiol 2002, 12:205-212.
7. Altmaier E, Russell D, Kao C, Lehmann T, Weinstein J: Role of selfefficacy in rehabilitation outcome among chronic low back pain patients. Journal of Couns Psychol 1993, 40:335-339.
8. Stevens JE, Pathare NC, Tillman SM, Scarborough MT, Gibbs CP, Shah P, Jayaraman A, Walter GA, Vandenborne K: Relative contributions of muscle activation and muscle size to plantarflexor torque during rehabilitation after immobilization. J Orthop Res 2006, 24:1729-1736.
9. Nilsson GM, Jonsson K, Ekdahl CS, Eneroth M: Unsatisfactory outcome following surgical intervention of ankle fractures. Foot Ankle Surg 2005, 11:11-16.
10. Lehtonen H, Jarvinen TL, Honkonen S, Nyman M, Vihtonen K, Jarvinen M: Use of a cast compared with a functional ankle brace after operative treatment of an ankle fracture. A prospective, randomized study. J Bone Joint Surg Am 2003, 85- A:205-11.
11. A.S. Dograa, A. Rangan. Early mobilisation versus immobilisation of surgically treated ankle fractures. Prospective randomised control trial. Injury, Int. J. Care Injured 30 (1999) 417±419.
12. Ahmed W, Alwe R, Wade D. One-year functional outcomes following major trauma: experience of a UK level 1 major trauma centre. Clin Rehabil. 2017 Dec;31(12):1646-1652.
13. Eiff MP, Smith AT, Smith GE. Early mobilization versus immobilization in the treatment of lateral ankle sprains. Am J Sports Med. 1994 Jan-Feb;22(1):83-8.
14. Dettori JR, Pearson BD, Basmania CJ, Lednar WM. Early ankle mobilization, Part I: The immediate effect on acute, lateral ankle sprains (a randomized clinical trial). Mil Med. 1994 Jan;159(1):15-20.
15. Thur CK, Edgren G, Jansson KA, Wretenberg P. Epidemiology of adult ankle fractures in Sweden between 1987 and 2004: a population-based study of 91,410 Swedish inpatients. Acta Orthop. 2012;83:276-281.
16. Rüedi TP, Murphy WM. AO Principles of Frac¬ture Management. Stuttgart, Germany: Thieme; 2000.
17. Vioreanu M, O’Briain D, Dudeney S, et al. Early exercising in removable cast compared with immobilisation in cast after operative treat¬ment of ankle fractures. A prospective ran¬domised study [abstract]. J Bone Joint Surg Br. 2006;88-B suppl 2:280.
18. Venesmaa P, Arokoski J, Airaksinen O, Eske¬linen J, Suomalainen O, Kröger H. Comparing postoperative immobilisation of ankle frac¬tures with Aircast or standard cast: a ran¬domised prospective study [abstract]. J Bone Joint Surg Br. 2004;86-B suppl 3:255-256.
19. Shaffer MA, Okereke E, Esterhai JL, Jr., et al. Effects of immobilization on plantar-flexion torque, fatigue resistance, and functional ability following an ankle fracture. Phys Ther. 2000;80:769-780.
20. Hedstrom M, Ahl T, Dalen N (1994) Early postoperative ankle exercise. A study of postoperative lateral malleolar fractures. Clin Orthop Relat Res. 193–196.
21. Lehtonen H, Jarvinen TLN, Honkonen S, Nyman M, Vihtonen K, Järvinen M. Use of a cast compared with a functional ankle brace after operative treatment of an ankle fracture.A prospetive randomized trial. J Bone Joint Surg Br Am. 2003;85:205–11.
22. Partio IK. Immobilisation and early mobilisation of malleolar fractures after osteosynthesis with resorbable bone screws. Unfallchirurgie 1992;18(15):304±10.]
23. van Staa TP, Dennison EM, Leufkens HG, Cooper C: Epidemiology of fractures in England and Wales. Bone 2001, 29:517-522. Court-Brown C, Caesar B: Epidemiology of adult fractures: A review. Injury 2006, 37:691-697.
24. Lash N, Horne G, Fielden J, Devane P: Ankle fractures: Functional and lifestyle outcomes at 2 years. ANZ J Surg 2002, 72:724-730.
25. Paul A. Matthews, Brigitte E. Scammell, Arfan Ali, Timothy Coughlin, Jessica Nightingale, et al. Early motion and directed exercise (EMADE) versus usual care post ankle fracture fixation: study protocol for a pragmatic randomised controlled trial. Trials. 2018; 19: 304.
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