OBJECTIVE: To evaluate the use of active controlled motion (ACM) after unstable ankle fractures needing initial partial weight-bearing. DESIGN: Prospective randomized controlled trial. SETTING: Inpatient and outpatient clinic. SUBJECTS: A total of 50 patients with unstable ankle fractures and the need for partial weight-bearing for six weeks. INTERVENTIONS: Randomization in two groups: physiotherapy alone or physiotherapy with an additional ACM device. MAIN MEASURES: Follow-up after 6 and 12 weeks. Range of motion, visual analogue scale for foot and ankle (VAS FA), Philip score, Mazur score, American Orthopaedic Foot and Ankle Society (AOFAS) score and dynamic pedobarography. RESULTS: Range of motion was better in the ACM group at six weeks (mean 49 degrees +/- 11.1 degrees versus 41.3 degrees +/- 8.1 degrees). Questionnaires revealed better outcome after six weeks in the VAS FA (56 +/- 13.7 versus 40.6 +/- 10.5), Mazur score (64.4 +/- 12.3 versus 56.7 +/- 11) and AOFAS score (71.2 +/- 12 versus 63.6 +/- 8.7) (p > 0.02 for all). Better outcome after 12 weeks in all questionnaires (VAS FA 77.7 +/- 13.8 versus 61.4 +/- 16.3; Philip score 79.1 +/- 10.9 versus 60.1 +/- 21.7; Mazur score 83.9 +/- 10.7 versus 73.1 +/- 14.1; AOFAS score 87.5 +/- 7.9 versus 75.2 +/- 11.7) (p < 0.01 for all). Pressure balance was better under the midfoot region after 12 weeks in the ACM group (delta P 4.4 N versus 34.0 N; p = 0.01). The ACM group had an earlier return to work after 10.5 (range 3 to 17) versus 14.7 (range 9 to 26) weeks (p = 0.02). CONCLUSION: The use of ACM for patients needing initial partial weight-bearing after operatively treated unstable ankle fractures in the first six postoperative weeks leads to better clinical and functional results and an earlier return to work.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher