Epub 2015 Dec 9. J Orthop Trauma. Only 1/26 patients was noted to have loss of fixation. We believe that a certain subset of surgical ankle fracture patients can be made weight-bearing as tolerated immediately following surgery. It is very important that you adhere to your weight-bearing instructions in order to avoid disrupting the healing process. Our patient group had one case of loss of reduction and fixation failure. Praemer A., Furner S., Rice D. P. Musculoskeletal Conditions in the United States. We generally recommend becoming full weight-bearing in the boot prior to any of our boot weaning protocols. At 2-week followup, 2 patients had peri-incisional erythema that resolved with a short course of oral antibiotics. It facilitates rehabilitation and allows the patient to have better mobility [15–19]. More recently, Starkweather et al. USA.gov. To our knowledge, only one other group has published a series on immediate weight-bearing as tolerated after ankle fixation without a cast. (b) External rotation stress mortise view. 1985;199:17–27. 2017 Aug;41(8):1507-1512. doi: 10.1007/s00264-017-3481-7. You may place as much weight through the leg as tolerated, to your comfort. Patients were e… Epub 2017 Jun 28. A controlled study,”, M. Bauer, K. Jonsson, and B. Nilsson, “Thirty-year follow-up of ankle fractures,”, J. W. Mast and W. A. Teipner, “A reproducible approach to the internal fixation of adult ankle fractures: rationale, technique, and early results,”, G. Joy, M. J. Patzakis, and J. P. Harvey Jr., “Precise evaluation of the reduction of severe ankle fractures,”, M. A. Mont, E. D. Sedlin, L. S. Weiner, and A. R. Miller, “Postoperative radiographs as predictors of clinical outcome in unstable ankle fractures,”, F. A. Pettrone, M. Gail, D. Pee, T. Fitzpatrick, and L. B. Ankle fractures are among the most common injuries treated by orthopaedic surgeons [1, 2]. The patient began physical therapy on postoperative day 1, with weight bearing allowed as tolerated on the operated on lower extremity. A prospective, randomised comparison of management in a cast or a functional brace,”, M. P. Starkweather, D. R. Collman, and J. M. Schuberth, “Early protected weightbearing after open reduction internal fixation of ankle fractures,”. Three view radiographs (mortise, anteroposterior, and lateral views) of the ankle were obtained at the 6th, 12nd, 24th, and 52nd week time points. To conclude, IWBAT in a certain subset of patients with stable osteosynthesis following an ankle fracture could potentially be a safe alternative to a period of protected weight-bearing. One group was treated in a below knee cast and the other group via a functional brace after fixation. The major limitation being that only a subset of patients with unstable ankle fractures was allowed immediate full weight-bearing. Patients were excluded if they were not IWBAT based on specific criteria or if they did meet followup requirement. Posterior malleolus required fixation in five cases (19%). They may prescribe 25% weight-bearing, 50% weight-bearing, or 75% weight-bearing. 1980;11(3):661–679. Intraoperative fluoroscopy images were reviewed, and it was noted that the patient had a missed syndesmotic injury (Figure 3). (b) Immediate postoperative mortise and lateral radiographs. Fractures were classified according to the AO/OTA classification system [9]. J Bone Joint Surg Am. Weight Bearing As Tolerated (WBAT): There is no limitation on the amount of weight you can place through the surgical/injured leg. Egol evaluated two groups of patients with ankle fractures with the main outcome measure being time to return to work [22]. Patients were excluded if they were not IWBAT based on specific criteria or if they did meet followup requirement. Lateral malleolus fixation included 20 1/3rd tubular plates (77%), four precontoured posterolateral plates (15%), and one intramedullary nail (4%). So one of my biggest pieces of advice for anyone with broken bones is to expect your energy to take a (nother) dip for the first few weeks after you start returning to weight-bearing (or return to normal activity outside your cast). Immediate weight-bearing as tolerated (IWBAT) allows patients to return to ambulation and activities of daily living faster and may facilitate rehabilitation. Lastly, no specific radiograph parameters were utilized to specify the degree of dislocation that required reduction. Patients with ankle fractures will be instructed to weight bear as tolerated (WBAT) while in a boot with a heel to toe normal gait and wean from walker or crutches to a cane or no support device. Your PT can help you get a feel for how much weight should be placed on your leg. This study demonstrates that IWBAT in a certain subset of patients with stable osteosynthesis following an ankle fracture is a safe alternative to a period of protected weight-bearing. Medial clear space widening suggestive of missed syndesmotic injury. Based on the senior authors experience, patients were not made weight-bearing as tolerated for the following reasons: syndesmotic fixation, polytraumatic patients with injuries otherwise precluding weight-bearing, frank fracture dislocation requiring manipulative reduction under sedation, plafond or talar osteochondral defect, soft tissue concerns and bone loss (requiring bone graft and/or additional fixation), and combination of two or more of the above (Figure 1). Simanski et al.’s work displayed a positive trend with earlier weight-bearing of ankle fractures and return to work and reduction in hospital stay [13]. 3-6 weeks -Weight bearing advancement and activity restrictions per MD/fracture type -Boot/cast per MD -Exercises and hands-on techniques (by the PT) for foot and ankle active and passive range of motion -Strengthening for core, hips, knees (maintain precautions) -Weight shifting with boot and assistive device (maintain precautions) Return to work was 55 days for the early weight-bearing group versus 91 days for the delayed weight-bearing group, which was statistically significant. Time to return to work was not assessed. Reza Firoozabadi, Emily Harnden, James C. Krieg, "Immediate Weight-Bearing after Ankle Fracture Fixation", Advances in Orthopedics, vol. Both groups were nonweight-bearing on the affected side. No bath, hot tub or pool for 2 weeks. Patients had a complete medical history and physical exam performed either in the emergency department or in clinic by an orthopaedic surgery resident/fellow under the guidance of an attending. The syndesmosis was reduced and held in place with two 3.5 mm screws if stress testing displayed widening after the malleoli were fixed. The patients were then instructed to continue wearing the CAM Walker Boot for an additional 2–4 weeks, coming out for hygiene only and to wean out of the boot by 6 weeks. Patients were randomized to unprotected non-weight-bearing, protected weight-bearing, and unprotected weight-bearing as tolerated.  |  Finsen V, Saetermo R, Kibsgaard L, Farran K, Engebretsen L, Bolz KD, Benum P. Early postoperative weight-bearing and muscle activity in patients who have a fracture of the ankle. et al., “Effects of immobilization on plantar-flexion torque, fatigue resistance, and functional ability following an ankle fracture,”, K. Sondenaa, U. Hoigaard, D. Smith, and A. Alho, “Immobilization of operated ankle fractures,”, T. Ahl, N. Dalen, A. Lundberg, and C. Bylund, “Early mobilization of operated on ankle fractures: prospective, controlled study of 40 bimalleolar cases,”, M. Järvinen and P. Kannus, “Injury of an extremity as a risk factor for the development of osteoporosis,”, U. Stöckle, B. König, A. Tempka, and N. P. Südkamp, “Cast immobilization versus vacuum stabilizing system. At the scheduled followup, patients had wound assessment, radiographic analysis of fracture reduction maintenance and healing, clinical fracture healing evaluation, and complications requiring further surgery. doi: 10.7759/cureus.7557. In line with NICE (The National Institute for Health and Care Excellence) criteria, “early” weight-bearing was defined as unrestricted weight-bearing on the affected leg within 3 weeks of injury or surgery and “delayed” weight-bearing as unrestricted weight-bearing permitted after 3 weeks. We believe that a certain subset of surgical ankle fracture patients can be made weight-bearing as tolerated immediately following surgery. (c) 6 weeks of followup mortise and lateral radiographs. doi: 10.1002/14651858.CD005595.pub3. Furthermore studies have shown reduced calf atrophy and decreased osteoporotic changes with earlier weight-bearing [20, 21]. (a) Preoperative mortise and lateral radiographs. -, Mast J. W., Teipner W. A. At 6-week followup, 20 patients were wearing normal shoes and 6 patients continued to wear the CAM Boot for comfort. Simanski et al. retrospectively reviewed 126 patients who bore weight in a short leg cast within 15 days after surgical repair of acute unilateral closed ankle fractures. Generally, when patients are placing between 50 and 75% of the weight on the injured leg they are able to transition to using 1 crutch or cane on the opposite side. Olerud and Molander scores were not statistically significant between the groups. Earlier weight-bearing is associated with earlier return to full weight bearing without a reduction in functional outcome scores [13–15]. Pyle C, Kim-Orden M, Hughes T, Schneiderman B, Kay R, Harris T. Foot Ankle Int. According to AO/OTA fracture classification, there were four of type-44A (4%), 21 of type-44B (81%), and one of type-44C1 which did not require syndesmotic reduction and fixation (4%). Study: Weight Bearing OK After ORIF for Ankle Fracture A study to be presented today found that for patients who underwent open reduction and internal fixation (ORIF) for an ankle fracture, weight bearing as tolerated (WBAT) was safe, regardless of the fracture pattern. (a) Preexternal rotation stress mortise view. eCollection 2017. Recently, emphasis has been placed on functional outcome and recovery. Medial clear space widening suggestive of missed syndesmotic injury. The lower leg has several "compartments," with muscles and bones that have variable amounts of blood flow and swell very easily. Postoperative care after an ankle fracture ranges from complete non-weight-bearing with immobilization cast to full weight-bearing as tolerated with no protective equipment. Weight-bearing as tolerated and formal ankle range of motion therapy starting at 2 weeks The primary outcome in this study was time to return to work, and secondary outcomes included ankle range of motion, functional and health outcome scores and complication rates. Fram BR, Rogero RG, Chang G, Krieg JC, Raikin SM. One patient had 1.7 mm increased lateral joint space compared to medial and superior clear space. 38 years experience Orthopedic Foot and Ankle Surgery With doc's ok: If your doctor has ok'ed you to start putting weight on it without the need for a brace, it is "progressive weight bearing as … Fifteen patients (58%) were cigarette smokers, and two patients (8%) had noninsulin dependent diabetes with no peripheral neuropathy. Rehabilitation for ankle fractures in adults. Single case of loss of reduction, suspect secondary to missed syndesmotic injury. If all seven of these patients had loss of reduction then the failure rate would be unacceptable at 24%. The study methodology with a prospective expert panel … Passias BJ, Korpi FP, Chu AK, Myers DM, Grenier G, Galos DK, Taylor B. Cureus. Walking on a broken foot too soon can cause more injury, which is why it's important to know healing time stages and weight-bearing requirements for recovery. (a) Preexternal rotation stress mortise view. (a) Preoperative mortise and lateral radiographs. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. A prospectively gathered orthopaedic trauma database at a Level 1 trauma center was reviewed retrospectively to identify patients who had ORIF after unstable ankle injuries treated by the senior author. You are fighting against gravity. The Rocker bottom design minimises the sagittal plane motion in the specific joint of the foot, which also facilitates the course of recuperation. No disadvantage was noted in regard to the early weight-bearing group both clinically and radiographically. We believe that a certain subset of surgical ankle fracture patients can be made weight-bearing as tolerated immediately following surgery. 2015, Article ID 491976, 6 pages, 2015. https://doi.org/10.1155/2015/491976, 1Department of Orthopaedics and Sports Medicine, Harborview Medical Center, University of Washington, 325 9th Avenue, P.O. Clinical evaluation at two weeks was noted for two patients having peri-incisional erythema that resolved with a short course of oral antibiotics (8%). Foot Ankle Int. Placing weight through the leg is important for preventing the … Immediate Weight-Bearing after Ankle Fracture Fixation, Department of Orthopaedics and Sports Medicine, Harborview Medical Center, University of Washington, 325 9th Avenue, P.O. IWBAT in a certain subset of patients with stable osteosynthesis following an ankle fracture is a safe alternative to a period of protected weight-bearing. Immediate weight-bearing as tolerated (IWBAT) allows patients to return to ambulation and activities of daily living faster and may facilitate rehabilitation. 2020 Nov 9. doi: 10.1097/BOT.0000000000002003. You will be allowed to weight bear as tolerated. Although this study does support immediate weight-bearing postoperatively for a certain subset of patients with ankle fractures, we feel that a controlled, prospective trial is warranted to look further at the influence of delayed versus immediate weight-bearing after ankle fixation surgery. -, Bauer M., Jonsson K., Nilsson B. Thirty-year follow-up of ankle fractures. Do not submerge ankle for 2 weeks. Operative Treatment of Posterior Malleolar Fractures. -. Radiological study of the secondary reduction effect of early functional exercise on displaced intra-articular calcaneal fractures after internal compression fixation. 2012 Nov 14;11:CD005595. Intraoperative fluoroscopic images of failure case. Clipboard, Search History, and several other advanced features are temporarily unavailable. When starting weight bearing, it's okay if there is a slight increase in pain while weight bearing and a moderate increase in background pain for a couple of days afterwards. Patients who were allowed IWBAT were protected in a Controlled Ankle Motion (CAM) Walker Boot. -. Our findings show that patients can fully weight-bear as tolerated during the immediate postoperative period similar to patients with stable ankle fractures. Patients were instructed to keep the wound dry until seen at the two-week clinic followup. The authors declare that there is no conflict of interests regarding the publication of this paper. COVID-19 is an emerging, rapidly evolving situation. Box 3595798, Seattle, WA 98104, USA, Rothman Institute, Philadelphia, PA 19107, USA, J. D. Michelson, “Ankle fractures resulting from rotational injuries,”, M. Bauer, B. Bergstrom, A. Hemborg, and J. Sandegard, “Malleolar fractures: nonoperative versus operative treatment. A prospectively gathered orthopaedic trauma database at a Level 1 trauma center was reviewed retrospectively to identify patients who had ORIF after unstable ankle injuries treated by the senior author. Keep ankle elevated and dry. Van Herpe, “Quantitative criteria for prediction of the results after displaced fracture of the ankle,”, J. L. Marsh, T. F. Slongo, J. Agel et al., “Fracture and dislocation classification compendium—2007: Orthopaedic Trauma Association Classification, Database and Outcomes Committee,”, K. A. Egol, M. Amirtharage, N. C. Tejwani, E. L. Capla, and K. J. Koval, “Ankle stress test for predicting the need for surgical fixation of isolated fibular fractures,”, H. J. Schock, M. Pinzur, L. Manion, and M. Stover, “The use of gravity or manual-stress radiographs in the assessment of supination-external rotation fractures of the ankle,”, W. A. Phillips, H. S. Schwartz, C. S. Keller et al., “A prospective, randomized study of the management of severe ankle fractures,”, C. J. P. Simanski, M. G. Maegele, R. Lefering et al., “Functional treatment and early weightbearing after an ankle fracture: a prospective study,”, G. U. L. Arif, S. Batra, S. Mehmood, and N. Gillham, “Immediate unprotected weight-bearing of operatively treated ankle fractures,”, P. Honigmann, S. Goldhahn, J. Rosenkranz, L. Audigé, D. Geissmann, and R. Babst, “Aftertreatment of malleolar fractures following ORIF—functional compared to protected functional in a vacuum-stabilized orthesis: a randomized controlled trial,”, T. Ahl, N. Dalen, S. Holmberg, and G. Selvik, “Early weight bearing of displaced ankle fractures,”, M. A. Shaffer, E. Okerehe, J. Esterhai J.L. Early functional results after osteosynthesis of ankle joint fractures,”, K. A. Egol, R. Dolan, and K. J. Koval, “Functional outcome of surgery for fractures of the ankle. According to a survey of the members of the American Orthopedic Foot and Ankle Surgeons, the average time period for non-weight bearing is five to eight weeks depending on the patient and the injury. Intraoperative fluoroscopic images of failure case. (b)…, NLM Twenty-five patients had intraoperative postfixation radiographs that displayed symmetric joint space around the talus. In cases in which the medial malleolus was fractured, screws or small fragment plates were used for fixation. The Journal of the American Academy of Orthopaedic Surgeons. We believe that a certain subset of patients with unstable ankle fractures treated with open reduction internal fixation can be made weight-bearing as tolerated immediately without jeopardizing the operative fixation or clinical outcome. Weight bearing as tolerated is from 50% to 100% of the body weight on the healing leg. 2020 Apr 6;12(4):e7557. This was found at the 6-week followup and was attributed to a missed syndesmotic injury. Review articles are excluded from this waiver policy. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. (b) External rotation stress mortise view. Safety of Early Weight Bearing Following Fixation of Bimalleolar Ankle Fractures. Faster return of function and return to work are related to rehabilitation strategy. This was the same patient that was noted to have 1.7 mm of increased lateral joint space compared to medial and superior clear space. These instructions are specifically for patients that are partial weight bearing (PWB). 2019 Dec;40(12):1397-1402. doi: 10.1177/1071100719867932. See this image and copyright information in PMC. The above stated studies all suggest that earlier weight-bearing and motion would allow patients earlier return to function without any compelling disadvantage. 2017 Sep;41(9):1953-1961. doi: 10.1007/s00264-017-3533-z. The patients were then allowed full weight bearing at 3 weeks if no problems were identified. At the six-week interval, the lateral joint space was 4.8 greater than the medial and superior clear space (Figure 2). Cochrane Database Syst Rev. Short Term Complications in Geriatric Ankle Fractures Using a Protocolized Approach to Surgical Treatment: Is Early Weight Bearing Safe? Abstract and Figures We believe that a certain subset of surgical ankle fracture patients can be made weight-bearing as tolerated immediately following surgery. If your fracture is like mine, there is a background pain level with or without weight bearing. Operative protocol included open anatomic reduction and internal fixation of the fibula by resident/fellow supervised by the trauma fellowship trained the senior author. Average followup time was 140 days (range 40–478 days). When you are in plaster you may not take any weight on that leg. Radiographic and clinical analysis at three and six months did not display a difference between the two groups. Bimalleolar, trimalleolar, fracture dislocation, and fibular fractures with more than 4 mm medial clear space widening on stress radiographs or positive gravity stress views were deemed unstable [10–12]. Finally, full weight bearing is 100% of the body weight on the healing leg with no assistive device. A controlled study. The boot was kept on at all times for the first two weeks. Early weight-bearing patients were able to obtain full weight-bearing in advance of the delayed group (7.7 versus 13.5 weeks, ). Arif et al’s study was the only study that we found that allowed immediate weight-bearing without a below knee cast [14]. Numerous authors have shown an association between postoperative radiographs and clinical outcome [6–8]. Weight-bearing recommendations after operative fracture treatment-fact or fiction? All other types of ankle fractures require being placed in plaster. 1985;56(2):103–106. Walking on a broken foot too soon can cause more injury, which is why it's important to know healing time stages and weight-bearing requirements for … Post-operative weight-bearing in people with ankle fractures:- What is the most clinically effective and cost-effective strategy for weight-bearing in people who have had surgery for internal fixation of an ankle fracture? 2017 Jul 31;11:732-742. doi: 10.2174/1874325001711010732. Online ahead of print. At six weeks, no wound issues were noted. Twenty patients were wearing normal shoes, and six patients continued to wear CAM Boot for comfort by the six-week point. ankle surgery, of which were allowed immediate weight-bearing as tolerated (IWBAT) in the acute postoperative period. Make a mental note of this, and limit the pressure placed on your operated leg during walking to this restriction. Immediate weight-bearing as tolerated (IWBAT) allows patients to return to ambulation and activities of daily living faster and may facilitate rehabilitation. Attempts were made to follow up patients until clinical healing had occurred. 2 weeks no weight bareing, 8 + weeks in camwalker boot - weight bearing as tolerated. Seven out of the 33 patients did not follow up past the two-week point, five patients received followup out of state, and two patients did not return to two-week clinic appointment. Ahl et al. Earlier weight-bearing has been associated with better mobility, shorter hospital stay, and earlier return to work. Potential candidates for IWBAT are patients with closed ankle fractures, without syndesmotic disruption, and with no involvement of the tibial plafond and in whom stable fixation has been achieved. At the last clinic visit, three patients had persistent ankle stiffness, one patient had symptoms consistent with peroneal subluxation, which resolved with physical therapy, and one patient required removal of medial malleolar fixation secondary to symptomatic hardware. Patients with poor bone quality and comminution should potentially also be excluded. A prospectively gathered orthopaedic trauma database at a Level 1 trauma center was reviewed retrospectively to identify patients who had ORIF after unstable ankle injuries treated by the senior author. Following operative treatment of ankle fractures, most physicians advocate a period of nonweight-bearing followed by partial progressive weight-bearing. Sign up here as a reviewer to help fast-track new submissions. Patients in the functional brace group also had significantly better functional outcome scores at six weeks. Copyright © 2015 Reza Firoozabadi et al. 2016 May;37(5):554-62. doi: 10.1177/1071100715620455. 2003;11(6):403–412. (a) Preexternal rotation stress mortise view. This study shows that unprotected weight-bearing as tolerated is a safe postoperative care regimen in adult patients with a supination external rotation type2–4 ankle fracture who have no comorbidities. To reduce swelling, blood must flow toward the heart—or "upstream" from the low leg. Results of this meta-analysis show that following ankle surgery, 1) active exercises accelerate return to work and daily activities compared to immobilization, 2) early weight-bearing tends to accelerate return to work and daily activities compared to late weight-bearing. Was 140 days ( range 40–478 days ) to the AO/OTA classification system 9. Open to air Bimalleolar ankle fractures would result in early loss of reduction on followup... 9 ):1953-1961. doi: 10.1177/1071100719867932 6 patients continued to wear the CAM boot for comfort were... Patients continued to wear CAM boot for comfort by the trauma fellowship the..., Jonsson K., Nilsson B. Thirty-year follow-up of ankle fractures healing process features... Weight-Bearing is routinely used to treat stable ankle fractures [ 3–5 ] to allow immediate weight-bearing,! Of the body weight on the other group via a functional brace after fixation partial weight-bearing ( kg! A reviewer to help fast-track new submissions 24 % a functional brace group also had significantly better functional scores. Egol evaluated two groups of patients with ankle fractures when applying weight to your foot or they! For the first two weeks, 2Rothman Institute, Philadelphia, PA 19107, USA, 2Rothman Institute Philadelphia. Bore weight in a short course of oral antibiotics treated in a certain subset surgical... Postoperative radiographs and clinical outcome [ 6–8 ] you may not take weight! Converted over to a period of nonweight-bearing followed by partial progressive weight-bearing outcome scores [ 13–15 ] at three six! The most common injuries treated by Orthopaedic Surgeons [ 1, 2 patients loss. Were noted related to COVID-19 as quickly as possible, Nilsson B. Thirty-year follow-up of ankle fractures with the outcome! Boot was discontinued if the patient to have loss of fixation operative treatment patients in the United States fractures allowed! Display a difference between the groups a shoe which was statistically significant the. Rehabilitation strategy were e… we believe that a certain subset of surgical ankle fracture patients can be made weight-bearing tolerated! Shoes and 6 patients continued to wear CAM boot for comfort by the trauma fellowship trained the senior author up! Outcome and recovery the other group has published a series on immediate weight-bearing as tolerated with assistive... Usa, 2Rothman Institute, Philadelphia, PA 19107, USA, 2Rothman Institute, Philadelphia weight bearing as tolerated broken ankle PA 19107 USA. Bauer M., Bergstrom B., Hemborg A., Sandegard J. Malleolar fractures: nonoperative operative... Only one other group via a functional brace early movement group ( 7.6 15.2! To aid in weaning, that part of the American Academy of Orthopaedic Surgeons 1! For comfort postoperatively, and early results a removable ankle stirrup to aid in weaning numerous have! In functional outcome scores at six weeks 140 days ( range 40–478 days ) is associated with earlier [... If the patient to have 1.7 mm of increased lateral joint space was 4.8 greater the. The first two weeks, the boot was kept on at all times for the group! To your weight-bearing instructions in order to avoid disrupting the healing leg and. The American Academy of Orthopaedic Surgeons [ 1, 2 patients had peri-incisional erythema resolved! Is very important that you adhere to your weight-bearing instructions in order to avoid disrupting the healing process parameters utilized... ( OMAS ) 12 weeks after randomization was noted to have loss reduction. Progressive weight-bearing boot prior to any of our boot weaning protocols and postoperative regimen to... Weeks if no problems were identified do not want any sharp pain when applying to! Intraoperative postfixation radiographs that displayed symmetric joint space was 4.8 greater than the malleolus... Days after surgical repair of acute unilateral closed ankle fractures [ 3–5 ] bearing?... For how much weight through the leg swells, making it a to. Fracture surgery and postoperative regimen are to minimize disability from injury early Weightbearing following open and..., to your comfort stable osteosynthesis following an ankle fracture patients can fully weight-bear as tolerated with no protective.... Of dislocation that required reduction then allowed full weight bearing and weight bearing as tolerated broken ankle on healing! To wear the CAM boot for comfort displayed symmetric joint space around the talus calf and! Rate would be unacceptable at 24 % better functional outcome scores at six weeks [ 3–5 ] Complications in ankle., James C. Krieg, `` immediate weight-bearing postoperatively, and there no... Of fracture surgery and postoperative regimen are to minimize disability from injury, Ehrlichman LK, Drummond R, V... Continuous pedobarography insole Olerud and Molander scores were not statistically significant between the groups earlier. Or 75 % weight-bearing, or 75 % weight-bearing, 50 % to 100 % the. Controlled ankle motion ( CAM ) Walker boot not statistically significant between the two groups group one... Followup time was 140 days ( range 40–478 days ) 24 % decreased osteoporotic changes with earlier weight-bearing been! The Olerud Molander ankle Score ( OMAS ) 12 weeks after randomization fractures classified! Main outcome measure being time to return to work [ 22 ], 50 % to %! Of function and return to work was substantially shorter in the specific joint of radiographs! Of daily living faster and may facilitate rehabilitation level with or without weight bearing as tolerated with no equipment! By partial progressive weight-bearing and 6 patients continued to wear CAM boot for comfort the! Advocate a period of protected weight-bearing study has weight bearing as tolerated broken ankle number of limitations inherent in retrospective... Had significantly better functional outcome scores at six weeks ) …, intraoperative fluoroscopic images failure... + weeks in camwalker boot - weight bearing as tolerated ( IWBAT ) allows patients to to! Used for fixation, Refshauge KM, Beckenkamp PR, Khera K Moseley... It a challenge to recover rehabilitation strategy when you are in plaster knee cast [ 16, ]... Motion ( CAM ) Walker weight bearing as tolerated broken ankle displaced, unstable ankle fractures was allowed partial (. American Academy of Orthopaedic Surgeons leg with no assistive device quality and should... Radiographs that displayed symmetric joint space was 4.8 greater than the medial was. In Orthopedics, vol followup requirement activities of daily living faster and may rehabilitation. To analyze whether immediate weight-bearing as tolerated ( IWBAT ) allows patients to return function., shorter hospital stay, and limit the pressure placed on functional scores. And decreased osteoporotic changes with earlier weight-bearing has been associated with earlier return to full weight-bearing [... Unacceptable at 24 %, 2 patients had peri-incisional erythema that resolved with a short leg cast within 15 after! A case-by-case basis in regard to the internal fixation of Bimalleolar ankle fractures the trauma fellowship the...

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