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FACTORS RELATING TO THE RATE OF RECOVERY FROM ANKLE FRACTURES INCLUDING SLEEP PATTERNS



Abstract

We analysed factors affecting the rate of recovery from ankle fractures. Delays in return to normal functioning may relate to poorer quality and duration of sleep during recovery.

This prospective study investigates the relationship between the rate of recovery from ankle fracture and sleep disturbance, comparing ankle fractures classified using AO-Danis-Weber Classification – types A, B & C treated at Wellington Hospital, aged between 18 and 55 years. From June 2003 to October 2004 participants completed an ankle fracture questionnaire, and a general health profile at three, six and twelve months post-injury. A randomly selected subgroup was interviewed to identify specific recovery issues.

Six percent were Weber A, 56% B and 39%, C. Mean (and standard deviation) for return to normal functioning was; 5 (2); 8 (3) and 8 (7) weeks respectively, overall range – 2 to 24 weeks. Those who returned in 2 weeks had sedentary jobs, worked from home or were students, all with a high level of support by ACC. Physically demanding occupations delayed return to work. After one year, (93%) scored 85 – 90% satisfaction with their ankle performance. 97% scored highly on the SF 36, indicating positive life attitudes. 98% reported no change from their pre-fracture sleep patterns.

Rate of recovery is less predictable and sometimes more prolonged for Weber C than for A and B ankle fractures. Earlier return to work is a function of practical support in the workplace and positive health attitudes including balanced sleep patterns. Work planning and workplace assessment are significant factors.

The abstracts were prepared by Editorial Secretary Jean-Claude Theis. Correspondence should be addressed to NZOA at Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.