Early Active Mobilization Versus Cast Immobili-zation in Operatively Treated Ankle Fractures A Prospective Analysis of Early Functional Recovery

摘要

Purpose: A prospective trial was undertaken to assess if early postoperative mobilization improved functional outcome compared to traditional cast immobilization following open reduction and internal fixation of Weber"B" ankle fractures.Patients and Methods: The immobilized group remained in cast for 6 weeks. The mobilized group was free of plaster casting. Patients were assessed for pain, satisfaction, range of movements according to Lindsjo etal.and Olerud's&Molander'sfunctional outcome and radiologic appearance postoperatively.Results: There was a significantly greater range of motion in the mobilized group at 6 weeks.This advantage diminished at 12 weeks. Patients were also significantly more satisfied in the mobilized group at i-week follow-up. While satisfaction was insignificantly different at day 2 and week 6, pain scores were the same in both groups throughout.There was no significant difference in functional outcome at 6- and 12-week follow-up. Ra-diologically, there was no loss of reduction in both groups.Conclusion: The results indicate that earlier mobilization out of cast increases earlierfunctional outcome and loaded range of motion. These earlier advantages appear to diminish at later follow-up. Importantly, the study does not indicate an increased risk of loss of fracture reduction in the earlier mobilized group.