Very early prescription of range of motion exercises in ankle fractures treated with ORIF does not increase the rate of complications and reoperations: A survival risk analysis

被引：0

作者：

Llano, Lionel ^{[1
]}

Ignacio Theaux, Juan ^{[1
]}

Forti, Nehuen ^{[1
]}

Barbaglia, Victoria ^{[1
]}

Taype, Danilo ^{[1
]}

Sancineto, Carlos ^{[1
]}

Carabelli, Guido ^{[1
]}

Barla, Jorge ^{[1
]}

机构：

[1] Carlos E Ottolenghi Hosp Italiano Buenos Aires, Inst Ortopedia & Traumatol, Trauma Sect, Buenos Aires, DF, Argentina

来源：

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2023年 / 54卷

关键词：

Ankle fractures; Open reduction internal fixation (ORIF); Mobilization; Range of motion; Complications; reoperations; INTERNAL-FIXATION; WEIGHT-BEARING; OPEN REDUCTION;

D O I：

10.1016/j.injury.2023.111019

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: Ankle fractures are commonly treated with non-surgical or surgical (preferably ORIF) approaches based on fracture characteristics. The postoperative care regimens vary widely, and the impact of very early mobilization on complications and reoperation rates in ankle fractures treated with ORIF remains unclear. Methods: A retrospective analysis was conducted on ankle fractures treated between January 2014 and November 2020. Demographic and fracture characteristic data were collected. Very early prescription of range of motion exercises was defined as initiation within the first week after surgery, typically between the second and seventh postoperative day. Complications, reoperations, and time to these events were analyzed. Kaplan Meier survival analysis was performed to assess the risk of complications with very early mobilization. Results: A total of 299 patients met the inclusion criteria. The cohort included 83 unimalleolar, 77 bimalleolar, and 138 trimalleolar fractures. Of the patients, 116 (38.8%) underwent very early range of motion. Complications occurred in 45 events among 39 patients (13%), with 16 events (41%) in the very early range of motion group. Reoperations were required for 23 patients (3.67% of the cohort). No statistically significant differences were found in the analysis of complications, with a hazard ratio (HR) of 1.17, and in the adjusted analysis with an HR of 1.12. Similarly, the reoperation analysis showed no significant differences, with an HR of 0.85 and 0.68 in the adjusted analysis. Conclusion: Very early prescription of range of motion exercises in ankle fractures treated with ORIF is a safe approach, as it does not increase the rates of complications or reoperations compared to early or late mobilization. This study supports the use of very early mobilization as a rehabilitation method for ankle fractures.

引用

页数：4

共 10 条

[1]

Black J D J, 2013, Foot (Edinb), V23, P78, DOI 10.1016/j.foot.2013.05.002

[2] Early Weightbearing and Range of Motion Versus Non-Weightbearing and Immobilization After Open Reduction and Internal Fixation of Unstable Ankle Fractures: A Randomized Controlled Trial [J].