Early mobilization of operated on ankle fractures: Prospective, controlled study of 40 bimalleolar cases

Ahl, Torbjörn; Dalén, Nils; Lundberg, Arne; Bylund, Carin

doi:10.3109/17453679308994541

Cited by 86 publications

(103 citation statements)

References 22 publications

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“…Some researchers have found no difference [24]; others report a better functional outcome for functional rehabilitation as seen predominantly in the early postoperative phase (up to ten weeks), which then equates over time with outcomes for cast immobilisation [8,22]. However, early functional rehabilitation will generally not include an early increase in weight bearing, even though this might result in more rapid consolidation of the fracture [3,15]. A pre-condition is adequate stabilisation of the fracture, otherwise there is a risk of delayed bone union [5] or even secondary dislocation [13], which should be avoided for joint fractures requiring congruous reduction [14,20].…”

Section: Introductionmentioning

confidence: 99%

The dynamic vacuum orthosis: a functional and economical benefit?

Franke

Goldhahn

Audigé

et al. 2007

International Orthopaedics (SICO

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In a prospective, randomised study, 27 patients with internally fixed ankle fractures were treated postoperatively for a period of six weeks by application of either a new dynamic vacuum orthosis with permitted mobilisation to 10°-0°-10°at the ankle joint or a synthetic cast. Full weight bearing was allowed in both groups after two weeks. The cast group was prescribed four weeks of physiotherapy following six weeks of immobilisation. After ten weeks, the Olerud and Molander score showed a significant difference in favour of the orthosis. Early functional outcomes were significantly better for this group after six weeks and ten weeks. Patients in the orthosis group who were in formal employment returned to work 24 days earlier than those in the control group. Treatment of the orthosis patients took up three to four times less working time for the medical personnel. A saving of 38 euros on directly ascertainable costs could be evaluated. Rehabilitation of ankle fractures with a dynamic vacuum orthosis leads to better early functional results and greater patient satisfaction. The orthosis fulfils the conditions for early return to work. Treatment with an orthosis not only reduces working time for medical personnel but economises on expenditure for treatment and rehabilitation.

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Section: Introductionmentioning

confidence: 99%

The dynamic vacuum orthosis: a functional and economical benefit?

Franke

Goldhahn

Audigé

et al. 2007

International Orthopaedics (SICO

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“…After reading the full manuscript of these 19, 9 were initially included for the review, satisfying the inclusion/exclusion criteria. Five papers by Ahl et al [7,15,16,18,19] were identified. On closer inspection, these publications were a series of articles in which the same patients were included in more than one paper.…”

Section: Resultsmentioning

confidence: 99%

“…On closer inspection, these publications were a series of articles in which the same patients were included in more than one paper. In this case, the largest series was included in the overall analysis [19], and the smaller ones were rejected. Similarly, it appeared that the same patients were included in Finsen & Benum [20] and Finsen et al's [4] papers.…”

Section: Resultsmentioning

confidence: 99%

When Should Open Reduction and Internal Fixation Ankle Fractures Begin Weight Bearing? A Systematic Review

Smith

Davies

2007

Eur J Trauma Emerg Surg

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The objective of this paper was to review the literature to assess when open reduction and internal fixation ankle fractures should commence weight bearing for the best outcome. An electronic search was undertaken of the databases AMED, Cinahl, Embase, Medline (via Ovid), Pedro and Pubmed, from their inception to November 2005. References lists were scrutinised and a hand search was also performed. We included all English language, human subject, controlled clinical trials, comparing the effects of early against later weight bearing following open reduction and internal fixation of ankle fractures. Two reviewers independently assessed the methodological quality of the literature using the PEDro (Physiotherapy Evidence Database) scoring system. Five papers comprising of 366 ankle fractures were reviewed. Overall, there was no significant difference between commencing early, compared to later weight bearing in subjects following open reduction and internal fixation, when evaluated against function, pain, range of movement, radiological assessment, complications, and return to work. The evidence reviewed was generally poor, with numerous methodological design limitations. The literature suggested that were was little difference between encouraging early or delayed weight bearing after open reduction and internal fixation of ankle fractures. Neither early nor later weight bearing significantly improves or jeopardises outcomes. However, due to the plethora of methodological limitations and limited evidence, it is not possible to reference this conclusion with conviction. Further large, well-designed randomized controlled trials are required to evaluate this area.

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“…The casts (custom-made immobilization made of plaster or synthetic material), backslabs (half casts), and orthoses (commercially available braces) should be used for immobilization. The early passive (Davies 1991) or active (Lehtonen et al 2003) exercises and early weight-bearing (Ahl et al 1993) should be started during the period of immobilization after the surgery. Alternatively, some authors suggest functional exercise (Moseley et al 2005) and manual therapy (Wilson 1991) following the period of immobilization.…”

Section: Rehabilitation Program For Ankle Fracturesmentioning

confidence: 99%