Successful immediate weight-bearing of internal fixated ankle fractures in a general population

Several studies on operated ankle fractures have shown that immediate weight-bearing is recommendable. Consequently, we changed our postoperative standard regimen, from 3 weeks of non-weight-bearing followed by 3 weeks of weight-bearing, to full immediate weight-bearing in all 6 weeks. A below-knee walking cast was applied immediately after surgery. Between December 1995 and September 1996, we studied 62 patients (median age, 55 years; range 21-92 years; M/F, 24/38), with ankle fractures who attended our emergency department and were subsequently admitted for open reduction and internal fixation. We excluded patients with distal tibia fracture and patients under 18 years of age. Overall, our elderly population did not have complication rates higher than those reported in similar studies on younger patients. In 1 patient, we observed radiographic widening of the ankle joint, of about 3 mm, 6 weeks postoperatively. No patients required reoperation. Our study indicates that full immediate weight-bearing after open reduction and internal fixation is recommendable, even in an elderly population.