J Korean Foot Ankle Soc.  2017 Mar;21(1):21-26. 10.14193/jkfas.2017.21.1.21.

Clinical Outcome after Early Rehabilitation according to Injury Type in Ankle Fracture

• Song JW
• Lee HS
• Seo SG
• Ryu CH

• KMID: 2371970
• DOI: http://doi.org/10.14193/jkfas.2017.21.1.21

Abstract

PURPOSE
To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type.
MATERIALS AND METHODS
A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the Olerud-Molander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising.
RESULTS
Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking.
CONCLUSION
In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.

Keyword

Ankle fracture; Injury type; Early rehabilitation

MeSH Terms

Ankle Fractures*
Ankle*
Arthralgia
Classification
Exercise
Follow-Up Studies
Heel
Humans
Incidence
Joints
Ligaments
Male
Pain, Postoperative
Rehabilitation*
Retrospective Studies
Walking
Weight-Bearing

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