Feb 16, 2024
Postoperative care protocols for ankle
fracture surgery remain controversial with variability among care
providers. This prospective controlled trial compared 12-week
postoperative outcomes for immediate unprotected weightbearing
(IMWB) vs nonweightbearing (NWB) for 2 weeks in a splint followed
by weightbearing as tolerated (WBAT) in a boot after surgical
fixation of selected low-energy ankle fractures without superior
articular involvement.
In conclusion, in this short-term and
relatively small prospective trial, we found more wound
complications among patients treated with immediate unprotected
weightbearing compared with patients treated with 2 weeks of NWB
followed by protected weightbearing. Given the low incidence and
small sample size, we do not know if these observed findings are
generalizable. However, we also found no difference in functional
outcomes at 12 weeks postoperation between these 2 groups. In light
of that, we do not recommend IMWB after open reduction internal
fixation of low-energy ankle fractures with plate and/or screw
fixation.
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