Early Protected Weightbearing After Open Reduction Internal Fixation of Ankle Fractures With Trans-syndesmotic Screws |
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| Affiliation: | 1. Attending Staff and Residency Director, Kaiser San Francisco Bay Area Foot and Ankle Residency Program, Kaiser Foundation Hospital, Oakland, CA;2. Fellow, Silicon Valley Reconstructive Foot and Ankle Fellowship, Mountain View, CA;3. Attending Staff, Kaiser San Francisco Bay Area Foot and Ankle Residency Program, Kaiser Foundation Hospital, Antioch, CA;4. Attending Staff, Foot and Ankle Surgery, Roseville Orthopedic Surgery & Sports Medicine, Roseville, CA;5. Attending Staff, Kaiser San Francisco Bay Area Foot and Ankle Residency Program, Department of Orthopedics, Kaiser Foundation Hospital, San Francisco, CA;1. Assistant Professor of Community and Preventive Medicine, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;2. General Practitioner, Department of Orthopedic Surgery, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;3. Associate Professor of Orthopedic Surgery and Orthopedic Foot & Ankle Surgeon, Department of Orthopedic Surgery, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;1. Senior Registrar, Department of Orthopedic Surgery and Traumatology, Kolding Hospital, a part of Lillebaelt Hospital, Kolding, Denmark;2. Consultant and Associate Professor, Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark;3. Consultant and Associate Professor, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark;4. Associate Professor, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark;5. Consultant, Department of Orthopedic Surgery and Traumatology, Kolding Hospital, a part of Lillebaelt Hospital, Kolding, Denmark;1. Attending Staff, Department of Orthopedic Surgery, Kaiser Permanente, San Francisco, San Francisco, CA;2. Attending Staff, Department of Podiatric Surgery, Kaiser Permanente, Oakland, Oakland, CA;3. Research Analyst, Division of Research, Kaiser Permanente, Oakland, Oakland, CA;4. Attending Staff, Kaiser Permanente, Sacramento, Sacramento, CA;5. Attending Staff, Department of Orthopedics, Division of Podiatric Surgery, Swedish Medical Center, Seattle, WA;6. Private Practice, Southern Arizona Orthopedics, Tucson, AZ;1. Research Fellow, Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH;2. Associate Professor, Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH;1. Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China;2. Department of Orthopaedics, People''s Hospital of Gaochun, Nanjing, Jiangsu Province, P.R. China |
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| Abstract: | ![]()
Traditional postoperative care after open reduction internal fixation (ORIF) of unstable ankle fractures with syndesmotic instability includes non-weightbearing for 6 to 8 weeks. However, prolonged non-weightbearing may be detrimental. The goal of this case series was to assess the outcomes of early protected weightbearing after operative treatment of acute ankle fractures with syndesmotic instability requiring screw stabilization. Fifty-eight consecutive patients, treated from January 2006 to January 2013, met the inclusion criteria with a minimum follow up of 1 year. Electronic medical records and radiographs were reviewed for patient and surgical characteristics, postoperative complications, and maintenance of reduction. Patients initiated walking at an average of 10 days (range 1 to 15) postoperatively. Surgical treatment consisted of operative reduction with standard fixation devices and 1 or 2 trans-syndesmotic screws that purchased 4 cortices. All 58 patients maintained correction after surgery when allowed to weightbear early in the postoperative recovery. Five complications (8.6%) occurred in the 58 patients, which included 3 superficial infections (5.2%) and 2 cases (3.4%) of neuritis. The maintenance of reduction and low complication rate in this study support the option of early protected weightbearing after ankle fracture ORIF with trans-syndesmotic fixation. |
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