EARLY RANGE OF MOVEMENT VERSUS CAST IMOOBILISATION IN PATIENTS POST OPEN REDUCTION AND INTERNAL FIXATION OF ANKLE FRACTURE – A PROSPECTIVE RANDOMISED CONTROL TRIAL

Abstract

Background: The main aim of this study is to compare the difference between early mobilisation versus non weight bearing in patients post ankle fracture fixation in terms of pain and functional outcome

Methods: We recruited 60 patients and were divide into two equal groups. Patients in Group A were treated with a below knee cast post ankle fracture fixation and remained non weight bearing for six weeks while groub B were patients that were treated with a backslab for two weeks post fixation. The backslab was removed and once their radiographs were deemed satisfactory, They were referred to the physiotherapy service in our unit for range of motion exercises while still remaining non-weight bearing. All patients were allowed to weight bear at six weeks time post fixation. The inclusion criteria included patients within the age of 18 to 40 years of age and all the fractures are classified using the Weber classification. Patients that were excluded from theses studies are those with unstable fractures and have high co-morbid conditions. All these patients were followed up at 2 weeks, 6 weeks, 3 months and 9 months post ankle fracture fixation. Pain and functional outcome were scored using the AOFAS scoring system.

Results: We found that patients in both these groups scored almost equally during the 2 week follow up but at 6 week, group B showed much better range of movement with less pain and a much higher satisfaction rate with their range of movement. However, at 9 months, patients in both group were able to return to their normal physical activity.

Conclusion: Our conclusion is that early mobilisation has an definite advantage over non weight bearing post ankle fracture with regards to functional outcome, pain scoring and patient satisfaction. Patient selection and compliance play a role in the outcome of the study.