![]() Fracture and operative information including number of malleoli involved, presence of associated dislocation, as well as type of fixation, use of a syndesmotic screw, postoperative immobilization, and weightbearing status were collected by a senior orthopaedic resident. History of any associated medical conditions was also noted using a standardized comorbidity listing. ![]() Eligible patients were approached by the research assistant independent of the surgeon and informed consent was obtained from willing volunteers.īaseline information was then collected by the research assistant through patient self-report and chart review. The surgeons reviewed the potential participant’s radiographs to determine if the fracture met the inclusion criteria. The research assistant screened new admissions to the orthopaedic service to identify patients with an ankle fracture. ![]() Secondarily, we examined the association of demographics, baseline clinical and fracture characteristics, and side-to-side difference in the WBLT and OMAS with return to prefracture activity over the first postoperative year. Our primary objective was to describe recovery over the first postoperative year after ankle fracture managed with ORIF in terms of (1) the side-to-side difference in the WBLT to evaluate functional dorsiflexion (2) the Olerud Molander Ankle Score (OMAS) to evaluate patient-reported outcomes (3) return to prefracture activity levels, including sports and (4) return to work (for those who were working at the time of fracture). 3 Because we were interested in return to prefracture activities including sports, the focus of this evaluation was those who were 18-65 years old. 6, 9Īlthough ankle fractures can occur at any age, they are most common in younger males with more high-energy trauma or older females with low-energy trauma, such as a fall from a standing height. Further, although return to prefracture activity levels appears to be an important outcome following ankle fracture, 13, 16 limited studies have investigated clinical factors associated with this outcome following an ankle fracture managed by ORIF. 8 Measuring weightbearing ankle dorsiflexion (ie, functional dorsiflexion) and using side-to-side difference in the WBLT may inform understanding of patients’ overall recovery after ankle fracture. 5 Normative data suggest that a side-to-side WBLT difference of greater than 1.5 cm likely indicates functional ankle impairment. The weightbearing lunge test (WBLT), commonly used in chronic ankle stability populations, 19 assesses weightbearing dorsiflexion. 12 More recent studies have emphasized other outcomes such as patient-reported outcome measures 15 or gait 17 to determine recovery after an ankle fracture, but have found that these measures do not fully explain recovery from fracture. 12, 15 Earlier studies of recovery often examined ankle range of motion (ROM) in a nonweightbearing position that does not reflect the functional loadbearing requirement of the ankle. Studies evaluating recovery after ankle fracture have used a variety of outcomes. 20, 23 Although full return to prefracture activities is generally anticipated, patients often report ongoing pain and stiffness that may restrict their activities or limit their recovery. Ankle fractures are common and frequently managed using open reduction and internal fixation (ORIF).
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