Early Weightbearing After Operatively Treated Ankle Fractures: A Biomechanical Analysis. 2016

Eric W Tan, and Norachart Sirisreetreerux, and Adrian G Paez, and Brent G Parks, and Lew C Schon, and Erik A Hasenboehler
Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

BACKGROUND No consensus exists regarding the timing of weightbearing after surgical fixation of unstable traumatic ankle fractures. We evaluated fracture displacement and timing of displacement with simulated early weightbearing in a cadaveric model. METHODS Twenty-four fresh-frozen lower extremities were assigned to Group 1, bimalleolar ankle fracture (n=6); Group 2, trimalleolar ankle fracture with unfixed small posterior malleolar fracture (n=9); or Group 3, trimalleolar ankle fracture with fixed large posterior malleolar fracture (n=9) and tested with axial compressive load at 3 Hz from 0 to 1000 N for 250 000 cycles to simulate 5 weeks of full weightbearing. Displacement was measured by differential variable reluctance transducer. RESULTS The average motion at all fracture sites in all groups was significantly less than 1 mm (P < .05). Group 1 displacement of the lateral and medial malleolus fracture was 0.1±0.1 mm and 0.4±0.4 mm, respectively. Group 2 displacement of the lateral, medial, and posterior malleolar fracture was 0.6±0.4 mm, 0.5±0.4 mm, and 0.5±0.6 mm, respectively. Group 3 displacement of the lateral, medial, and posterior malleolar fracture was 0.1±0.1 mm, 0.5±0.7 mm, and 0.5±0.4 mm, respectively. The majority of displacement (64.0% to 92.3%) occurred in the first 50 000 cycles. There was no correlation between fracture displacement and bone mineral density. CONCLUSIONS No significant fracture displacement, no hardware failure, and no new fractures occurred in a cadaveric model of early weightbearing in unstable ankle fracture after open reduction and internal fixation. CONCLUSIONS This study supports further investigation of early weightbearing postoperative protocols after fixation of unstable ankle fractures.

UI MeSH Term Description Entries
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D005593 Fracture Fixation, Internal The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment. Osteosynthesis, Fracture,Fixation, Internal Fracture,Fixations, Internal Fracture,Fracture Fixations, Internal,Fracture Osteosyntheses,Fracture Osteosynthesis,Internal Fracture Fixation,Internal Fracture Fixations,Osteosyntheses, Fracture
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000843 Ankle Joint The joint that is formed by the inferior articular and malleolar articular surfaces of the TIBIA; the malleolar articular surface of the FIBULA; and the medial malleolar, lateral malleolar, and superior surfaces of the TALUS. Ankle Syndesmosis,Articulatio talocruralis,Distal Tibiofibular Joint,Inferior Tibiofibular Joint,Talocrural Joint,Tibiofibular Ankle Syndesmosis,Tibiofibular Syndesmosis,Ankle Joints,Ankle Syndesmoses,Ankle Syndesmosis, Tibiofibular,Distal Tibiofibular Joints,Inferior Tibiofibular Joints,Joint, Ankle,Joints, Ankle,Syndesmosis, Ankle,Talocrural Joints,Tibiofibular Ankle Syndesmoses,Tibiofibular Joint, Distal,Tibiofibular Syndesmoses
D016474 Weight-Bearing The physical state of supporting an applied load. This often refers to the weight-bearing bones or joints that support the body's weight, especially those in the spine, hip, knee, and foot. Load-Bearing,Axial Loading,Loadbearing,Weightbearing,Axial Loadings,Load Bearing,Weight Bearing
D016512 Ankle Injuries Harm or hurt to the ankle or ankle joint usually inflicted by an external source. Ankle Sprains,Injuries, Ankle,Syndesmotic Injuries,Ankle Injury,Ankle Sprain,Injuries, Syndesmotic,Injury, Ankle,Injury, Syndesmotic,Sprain, Ankle,Sprains, Ankle,Syndesmotic Injury

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