Evaluation of functional outcome following ORIF of bimalleolar fractures of the ankle-A prospective study of 30 patients

Abstract

Bimalleolar fractures are common injuries, and stable fracture patterns can be treated conservatively, while complicated, unstable fractures would require surgical intervention. This study aimed to evaluate the functional outcome following ORIF (Open reduction and internal fixation) of these fractures. This was a study of 30 patients with bimalleolar fractures who presented between January 2013 to January 2016 treated with ORIF with a follow-up period of 3 years. Functional outcome was performed with the AOFAS (American Orthopaedic Foot and ankle society) score. The mean age of the patients was 41.6 years. There was a female preponderance seen in our study with the left side being more commonly affected. The mean time to fracture union was 12.13 weeks, and we had excellent outcomes in 18 patients, good in 10, while two patients had a fair result. We did not lose any of our patients to follow up. All of our patients were happy with the functional outcome achieved. No significant complications were seen in our study. ORIF in bimalleolar fractures enables restoration of the ankle mortise to an anatomical position and facilitates early mobilization of the ankle resulting in good functional outcomes.

Characteristics and Effectiveness of Postoperative Rehabilitation Strategies in Ankle Fractures: A Systematic Review

“…Of all studies, 40 23–61 described their postoperative rehabilitation strategy but did not evaluate effectiveness and 15 20–22,62–73 focused on evaluating the effectiveness of the postoperative rehabilitation strategy. This section reports only those 40 studies that described their postoperative rehabilitation strategy, focusing on weight-bearing, immobilization, and other therapy administered.…”

“…42–47,49–55,58 Other studies advised patients to remain non–weight-bearing for up to 10–12 weeks. 42,50,54,55,57,60 Several studies reported patients being non–weight-bearing until fracture healing was confirmed with radiographic evidence. 49,51,56,57,60…”

“…[42][43][44][45][46][47][49][50][51][52][53][54][55]58 Other studies advised patients to remain non-weightbearing for to 10-12 weeks. 42,50,54,55,57,60 Several studies reported patients being non-weight-bearing until fracture healing was confirmed with radiographic evidence. 49,51,56,57,60 Those studies that included separate cohorts with and without syndesmotic injury or repair 42,49,50,55 specified longer periods before full weight-bearing in patients with syndesmotic injury, usually 8-12 weeks compared with 4 to 6 weeks in patients without syndesmosis disruption.…”

“…In some studies, these devices were later replaced by removable casts, braces, or ankle stirrups to aid in weaning. 27,32,34,36,37,42,44 Wang et al 57 and Zhan et al 51 did not use any immobilization or devices, and 6 studies 24,28,29,50,59,60 did not report whether any devices were used by patients postoperatively.…”

“…27,30,31,33,34,38,40,41,44,49,50,53,54,74 All of the remaining studies only provided limited details or a brief explanation of the number of sessions and type of exercises, which primarily targeted range of motion, 24,39,42,43,[46][47][48]51,56,[59][60][61] strength, 47 proprioception, 46,47 and the number or timing of sessions. 23,25,28,29,45,46,56,57,59,60 Other studies gave more details of their programs involving timing of exercises 55 and range of motion. 54 Suciu et al 52 described their rehabilitation therapy in the greatest detail, outlining an exercise program spanning from in-hospital exercises to outpatient rehabilitation up to 12 weeks postsurgery.…”