Ankle motility is a risk factor for healing of chronic venous leg ulcers

Objective: To investigate the effect of ankle motility on chronic venous le g ulcer healing, and to relate this to calf pump function and muscle bulk. Methods: This was a prospective cohort study undertaken in a leg ulcer clin ic. Ankle motility, calf-ankle circumference ratio and calf pump power (der ived from digital photoplethysmography) were assessed as to their effect on ulcer healing rate. Thirty consecutive patients undergoing multi-layer com pression bandaging for open chronic venous ulcers were included. Results: Ankle motility was an independent risk factor for ulcer healing (p = 0.001, hazard ratio 1.08, 95% CI 1.03-1.13). Ankle motility correlated w ith calf-ankle circumference ratio (r = 0.48, p< 0.01). No relationship was found between photoplethysmography-derived calf Dump power, ankle motility or ulcer healing rate. Conclusions: Ulcers in legs with poor ankle motility are slower to heal and this may be related to reduced calf muscle bulk. Ankle exercises or physio therapy could be considered in such patients.