Ka. Egol et al., Functional outcome of surgery for fractures of the ankle - A prospective, randomised comparison of management in a cast or a functional brace, J BONE-BR V, 82B(2), 2000, pp. 246-249
Citations number
10
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
We randomised prospectively 60 consecutive patients who were undergoing int
ernal fixation of similar fractures of the ankle into two groups, one of wh
ich was treated by immobilisation in a below-knee cast and the other by a f
unctional brace with early movement. All were instructed to avoid weight-be
aring on the affected side. They were seen at 6, 12, 26 and 52 weeks. The f
unctional rating scale of Mazur et al was used to evaluate the patients at
each follow-up and we recorded the time of return to work. After one year t
he patients completed the SF-36 questionnaire.
By then 55 patients remained in the study, 28 (mean age 45.5 years) in grou
p 1 and 27 (mean age 39.5 years) in group 2, Those in group 2 had higher fu
nctional scores at each follow-up but only at six weeks was this difference
significant (p = 0.02). They also had higher mean SF-36 scores, but this d
ifference was significant only for two of the eight aspects investigated. F
or patients gainfully employed, not on workers' compensation, the mean time
from surgery to return to work was 53.3 days for group 2 and 106.5 days fo
r group 1; this difference was significant (p = 0.01). No patient developed
a problem with the wound or had loss of fixation.
Our findings support the use of a functional brace and early movement after
surgery for fractures of the ankle.