Early weight bearing of displaced ankle fractures

Ahl, Torbjörn; Dalén, Nils; Holmberg, Sara; Selvik, Göran

doi:10.3109/17453678709146394

Cited by 77 publications

(66 citation statements)

References 13 publications

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“…Although Ahl et al [19] presented much of their findings in their largest series of patients [19], they neglected to present their data evaluating the effects of swelling, strength and bone mineral content, which had been illustrated in their earlier papers [7,15,16]. Although the authors concluded that there was no significant difference with these outcomes, in subjects who commenced weight bearing one day post-operatively, compared to 4 weeks, these findings are important.…”

Section: Discussionmentioning

confidence: 52%

“…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%

“…Although the authors concluded that there was no significant difference with these outcomes, in subjects who commenced weight bearing one day post-operatively, compared to 4 weeks, these findings are important. Accordingly, replicating Ahl et al's studies [7,15,16,18,19], clearly demonstrating subject allocation, recruitment and patient flow, for each outcome, is suggested to supplement the findings presented in Ahl et al's [19] paper.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have advocated early full or partial weight bearing in the first post-operative days [6,7], whilst others advocate strict non-weight bearing for the first 4-8 weeks [8][9][10][11][12]. Authors have justified restricting weight bearing in order to protect against further soft tissue damage, and fracture displacement [4,13,14].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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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Section: Discussionmentioning

confidence: 52%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…Clinical studies have used RSA to assess the position of specific fragments during the time of healing in ankle fractures [1][2][3][4][5], trochanteric fractures [17,29,30,[35][36][37][38][39], high tibial osteotomies [33], tibial plateau fractures [44], and radial fractures [26,27]. For each of these studies, single RSA examinations were performed at prospective followups and interfragmentary displacement with time was measured.…”

Section: Introductionmentioning

confidence: 99%

Differentially Loaded Radiostereometric Analysis to Monitor Fracture Stiffness: A Feasibility Study

Chehade

Solomon

Callary

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Inability to accurately and objectively assess the mechanical properties of healing fractures in vivo hampers clinical fracture management and research. We describe a method to monitor fracture stiffness during healing in a clinical research setting by detecting changes in fracture displacement using radiostereometric analysis and simultaneously measuring applied axial loads. A method was developed for load application, positioning of the patient, and radiographic setup to establish the technique of differentially loaded radiostereometric analysis (DLRSA). A DLRSA examination consists of radiostereometric analysis radiographs taken without load (preload), under different increments of load, and without load (postload). Six patients with distal femur fractures had DLRSA examinations at 6, 12, 18, and 26 weeks postoperatively. The DLRSA method was feasible in a clinical setting. The method provides objective and quantifiable data for internally fixed fractures and may be used in clinical research as a tool to monitor the in vivo stiffness of healing femoral fractures managed with nonrigid internal fixation.

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Rehabilitation for ankle fractures in adults

Lin

Moseley

2006

Cochrane Database of Systematic Reviews

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Early weight bearing of displaced ankle fractures

Cited by 77 publications

References 13 publications

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

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

Differentially Loaded Radiostereometric Analysis to Monitor Fracture Stiffness: A Feasibility Study

Rehabilitation for ankle fractures in adults

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