We know that rest is rarely the best way to fully overcome an injury or illness, and in many instances, early weight bearing and movement can actually speed up functional recovery by better helping structures regain mobility and function. That sentiment appears to hold true for patients who are working their way back from an unstable ankle fracture.
Medical experts are still trying to determine the optimal postoperative management plan for unstable ankle fractures that are surgically corrected with internal fixation. To learn more about the best post-op management strategies, medical researchers decided to conduct a study to see how early weight-bearing (EWB) played in improved functional outcomes after these types of fractures. 52 adults with acute unilateral unstable ankle fractures treated through open reduction and internal fixation were included in the trial. Participants were split into two groups:
- EWB and mobilization (initiated after two weeks of non weight-bearing)
- Delayed weight-bearing (DWB, which involved six weeks of non weight-bearing after surgery)
Primary outcomes that were assessed included full time to weight-bearing, overall functional recovery as measured by the OMAS scale and when the participants were able to return to work. Secondary outcomes that were assessed included range of motion, physiotherapy sessions and complication rates. Both groups followed a standardized post-op rehab program, but the EWB group began protected weight-bearing and physiotherapy at two weeks post-op, whereas the DWB group waited six weeks before bearing weight and beginning the physiotherapy program.
Early Weight Bearing Results
Researchers were surprised when comparing the two recovery programs.. They found that patients in the EWB group:
- Had a faster return to work (roughly 10 days earlier on average)
- Needed fewer total physiotherapy sessions
- Had significantly higher OMAS scores
- Had faster range of motion recovery
- Had comparable complication and infection rates
“EWB and mobilization after internal fixation of unstable ankle fractures enhance functional recovery, accelerate rehabilitation, and reduce the time to return to daily activities without increasing complications,” researchers concluded. “However, given the modest sample size and single-center design, these findings should be interpreted cautiously, and confirmation in larger studies is needed before routine adoption.”
This study falls in line with how we typically approach care with patients. We push for early weight bearing and early mobility when appropriate, because medical research continues to showcase the benefits of early movement after surgery. We make sure you get this movement in a safe and constructive manner, but know that we’re going to push you to be active, and patients aren’t always receptive to early movement. Know that there is a method to our madness, and that studies have found that this early movement and weight bearing leads to better functional outcomes, so trust the process and get moving!