Gonzalez TA, Macaulay AA, Ehrlichman LK, Drummond R, Mittal V, DiGiovanni CW. The primary goals of fracture surgery and postoperative regimen are to minimize disability from injury. 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,”. Sign up here as a reviewer to help fast-track new submissions. Clinical evaluation at two weeks was noted for two patients having peri-incisional erythema that resolved with a short course of oral antibiotics (8%). 2012 Nov 14;11:CD005595. Abstract and Figures We believe that a certain subset of surgical ankle fracture patients can be made weight-bearing as tolerated immediately following surgery. At 6-week followup, 20 patients were wearing normal shoes and 6 patients continued to wear the CAM Boot for comfort. 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. More recently, Starkweather et al. Copyright © 2015 Reza Firoozabadi et al. You will be given 4 medications: 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 … When blood collects in a compartment, that part of the leg swells, making it a challenge to recover. Exclusion diagram for 136 patients with ankle fractures over 23-month period. Patients with poor bone quality and comminution should potentially also be excluded. Average followup time was 140 days (range 40–478 days). Weight-bearing recommendations after operative fracture treatment-fact or fiction? HHS -. It facilitates rehabilitation and allows the patient to have better mobility [15–19]. We are committed to sharing findings related to COVID-19 as quickly as possible. To our knowledge, only one other group has published a series on immediate weight-bearing as tolerated after ankle fixation without a cast. Lateral malleolus fixation included 20 1/3rd tubular plates (77%), four precontoured posterolateral plates (15%), and one intramedullary nail (4%). Immediate weight-bearing as tolerated (IWBAT) allows patients to return to ambulation and activities of daily living faster and may facilitate rehabilitation. ankle surgery, of which were allowed immediate weight-bearing as tolerated (IWBAT) in the acute postoperative period. Immediate Weight-Bearing after Ankle Fracture Fixation, Department of Orthopaedics and Sports Medicine, Harborview Medical Center, University of Washington, 325 9th Avenue, P.O. May remove dressing in 48 hours and leave open to air. Early weight-bearing patients were able to obtain full weight-bearing in advance of the delayed group (7.7 versus 13.5 weeks, ). Stable, non-displaced, isolated uni-malleolar fracture (without opposing ligament injury), can be splinted in short leg splint or boot (with ankle at 90 degrees) with early weight bearing as tolerated (Phillips 1985), Mehta 2014) Operative: Indications are loss of joint congruency (i.e. 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. Recently, emphasis has been placed on functional outcome and recovery. 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 … Online ahead of print. Our patient group had one case of loss of reduction and fixation failure. At the six-week interval, the lateral joint space was 4.8 greater than the medial and superior clear space (Figure 2). 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. At six weeks, no wound issues were noted. 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. 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. (b) External rotation stress mortise view. Intraoperative fluoroscopy images were reviewed, and it was noted that the patient had a missed syndesmotic injury (Figure 3). 2017 Jul 31;11:732-742. doi: 10.2174/1874325001711010732. If your fracture is like mine, there is a background pain level with or without weight bearing. Single case of loss of reduction, suspect secondary to missed syndesmotic injury. Finally, full weight bearing is 100% of the body weight on the healing leg with no assistive device. This was a retrospective study with one group of patients that were allowed weight-bearing as tolerated postoperatively without a cast, and the other group of patients were placed in a cast and made nonweight-bearing for 6 weeks. You may place as much weight through the leg as tolerated, to your comfort. Patients who were allowed IWBAT were protected in a Controlled Ankle Motion (CAM) Walker Boot. Clipboard, Search History, and several other advanced features are temporarily unavailable. When you are in plaster you may not take any weight on that leg. retrospectively reviewed 126 patients who bore weight in a short leg cast within 15 days after surgical repair of acute unilateral closed ankle fractures.