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Early mobilization of operated on ankle fractures. Prospective, controlled study of 40 bimalleolar cases
Ahl T, Dalen N, Lundberg A, Bylund C
Acta Orthopaedica Scandinavica 1993;64(1):95-99
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

40 patients with dislocated bimalleolar and trimalleolar ankle fractures took part in this randomized study. All ankles were operated on using cerclage, staples and pins. Active ankle movement with weight bearing in an orthosis was compared with active ankle movement without weight bearing using a dorsal splint. Stereophotogrammetric analysis showed small movements in the ankle mortise in both groups but conventional radiography revealed no fracture redislocation. The clinical results did not differ. This study was designed as the second part of a consecutive project. In the first part, early and late weight bearing in a cast without ankle movements was compared (Ahl et al 1987b). In comparing the first and the second parts of the study, a small but significant increase in fracture instability was observed in the early motion group. No lasting superior clinical result was achieved by early ankle movement. After operation on dislocated bimalleolar ankle fractures, early postoperative weight bearing in a walking cast is recommended.

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