Early Active Mobilization Versus Cast Immobilization in Operatively Treated Ankle Fractures

Abstract

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 et al. and Olerud’s & Molander’s functional 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 1-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. Radiologically, there was no loss of reduction in both groups.

Conclusion:

The results indicate that earlier mobilization out of cast increases earlier functional 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.