Early Mobilization of Operatively Fixed Ankle Fractures: A Systematic Review

Abstract

It is difficult to conclude whether early motion is overall better or worse than cast immobilization. The evidence suggests however that a young fit patient who needs to return to work may benefit from early motion of the ankle joint whereas a patient with poor skin or at risk of infection may be better treated in a cast after surgery.

A retrospective study of functional outcome of surgically managed malleolar fracture at the ankle joint by subjective, objective and radiological assessment

“…Based on the current literature, a patient with higher risk for postoperative infection should probably be treated with a cast following ankle fracture surgery [19] . In obese and diabetic patients a longer period of non-or partial weight bearing is recommended, as premature weight bearing is the greatest contributing factor to a loss of reduction in this patient population [20].…”

Complications in ankle fracture surgery

“…However, early mobilization has been associated with an increased risk for wound complications (Lehtonen et al 2003, Vioreanu et al 2007, Thomas et al 2009). Based on the current literature, a patient with higher risk for postoperative infection should probably be treated with a cast following ankle fracture surgery (Thomas et al 2009, Lin et al 2012, Keene et al 2014.…”

“…In a large population based study with 57,183 patients, the rate of revision ORIF following ankle fracture surgery was 0.8% within the first three postoperative months (Soohoo et al 2009). Although there is a large body of literature about ankle fractures, no studies have Lehtonen et al 2003, Thomas et al 2009 examined the true frequency of the most common types of postoperative malreduction necessitating early reoperation.…”

Treatment of a pregnant patient with bilateral traumatic bimalleolar ankle fracture: a case report

“…Bazı yazarlar erken dönemde rehabilitasyonun ameliyat bölgesinde erken enfeksiyon riskinin artışına neden olduğunu belirtmişlerdir. [16,17] Öte yandan yapılan çalışmalarda, ameliyat edilen ayak bileği kırıklarına erken dönemde rehabilitasyon uygulanan hastalarda daha erken işe dönüş ve daha hızlı eklem hareket açıklığı elde edildiği tespit edilmiştir. [16][17][18] Farsetti ve ark.…”

“…[16,17] Öte yandan yapılan çalışmalarda, ameliyat edilen ayak bileği kırıklarına erken dönemde rehabilitasyon uygulanan hastalarda daha erken işe dönüş ve daha hızlı eklem hareket açıklığı elde edildiği tespit edilmiştir. [16][17][18] Farsetti ve ark. [10] bimalleoler ve trimalleoler kırık nedeniyle anatomik yerleştirme ve içten tespit uyguladıkları 44 hastanın erken rehabilitasyon grubunda daha az osteoartrit gördüklerini ve daha iyi eklem hareket açıklığı elde ettiklerini belirtmişlerdir.…”