GAIT ASYMMETRY FOLLOWING SUCCESSFUL SURGICAL-TREATMENT OF ANKLE FRACTURES IN YOUNG-ADULTS

Forty patients (mean age, 22.8 years) admitted for displaced ankle fra cture were observed retrospectively to determine by clinical examinati on and measurement of plantar pressure distribution whether successful surgical treatment of ankle fractures led to gait symmetry, and wheth er intraindividual differences were related to fracture type and clini cal outcome. The mean followup was 18.5 months (range, 12-36 months). The deviation of gait was quantified using a symmetry index of the tot al impulse. Using a clinical score, 6 patients had unsatisfactory resu lts, and the remaining 34 had satisfactory results. The symmetry index of the good (-1.1%) and the poor results (-2.3%) decreased in the ran ge of a healthy control group (-0.31%, n = 90), indicating that overal l gait symmetry was achieved after trauma. The plantar pressure distri bution showed significant load asymmetries. There was increased loadin g in the lateral forefoot of the injured leg in patients with good res ults and decreased pressure under the metatarsal heads of patients wit h bad results. Although those asymmetries were related neither to frac ture type nor clinical outcome, the findings may illustrate compensati on mechanisms that are used to regain gait symmetry after ankle altera tion by trauma.