Early weight bearing and mobilization decrease perioperative complications in patients after ankle fracture; the...

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Rehabilitation Medicine

Background:

• Open reduction and internal fixation (ORIF) is standard for unstable ankle fractures (AF).
• Debate exists regarding optimal rehabilitation: prolonged non-weight bearing versus early functional treatment.
• This study compares early versus delayed weight bearing post-ORIF for AF.

Purpose of the Study:

• To compare functional outcomes and complication rates between early and delayed weight bearing after ORIF for AF.
• To determine if early weight bearing impacts recovery and patient-reported scores.
• To assess the safety and efficacy of accelerated rehabilitation protocols.

Main Methods:

• 1421 patients with AF undergoing ORIF were analyzed (TRON group).
• Patients were divided into early (E) and late (L) weight-bearing groups.
• A propensity score-matched algorithm created 294 pairs for comparison of AOFAS scores and complications.

Main Results:

• Early weight bearing (Group E) significantly reduced non-weight bearing and cast immobilization times.
• No significant difference in American Orthopedic Foot and Ankle Society (AOFAS) scores between groups.
• Group E showed significantly lower rates of deep infection (1.7% vs. 6.1%) and reoperation (2.0% vs. 7.8%).

Conclusions:

• Early weight bearing after surgical treatment for AF yields similar functional outcomes to delayed weight bearing.
• Early weight bearing is associated with reduced rates of deep infection and reoperation.
• Postoperative early weight bearing is recommended for surgically treated ankle fractures.