Immediate unprotected weight-bearing of operatively treated ankle fractures

The objective of this study was to determine whether immediate mobilisation and unprotected weight-bearing of rigidly internally fixed fractured ankles had a significant effect on ankle function or whether it predisposed the ankle to loss of reduction or hardware failure. Twenty five patients with operated Weber A/B/C fractures were allowed immediate full weight-bearing without a plaster and were compared with matched historical controls treated in a non-weight-bearing plaster cast. Matched-pair analysis revealed no differences for hospital stay and functional outcome on Olerud and Molander scoring system but significant difference in time until return to work (mean : 91.3 +/- 20.2 vs. 54.6 +/- 15.5 days). In the cast group four patients had postoperative complications; one patient had loss of internal fixation and one had non-union while four patients in the non cast group had mainly wound-healing related problems. Patients in the non cast group tolerated earlier full weight-bearing compared with patients in the cast group, and there were no disadvantages concerning hospital stay, pain intensities, and functional scores. Treating patients without plaster may result in faster rehabilitation.