Early Weightbearing and Mobilization Versus Non-Weightbearing and Mobilization in Unstable Ankle Fractures

Early Weightbearing and Mobilization Versus Non-Weightbearing and Immobilization After ORIF of Unstable Ankle Fractures: a Randomized Controlled Trial

The primary objective of the investigators randomized controlled trial is to determine if early protected weightbearing and ankle range of motion after surgical treatment (open reduction internal fixation - ORIF) for ankle fractures improves the rate of return to work and functional outcome compared to postoperative ankle immobilization in a non-weightbearing cast.

This is a randomized controlled trial comparing early weightbearing and mobilization VS immobilization and non-weightbearing after initial treatment of unstable ankle fractures.

The primary objective of our randomized control trial is to determine if early protected weightbearing and ankle range of motion post open reduction internal fixation (ORIF) for unstable ankle fractures improves the rate of return to work and functional outcome compared to postoperative ankle immobilization in a non-weightbearing cast.

Our secondary objective is to determine the rate of adverse events (wound healing, infection, hardware failure) with early weightbearing and ROM comparable to rates with traditional post-op ankle immobilization.

Inclusion Criteria:

• Unilateral unstable ankle fracture requiring surgical stabilization
• Treatment within two weeks of injury
• Closed or low grade open ankle fracture (grade 1 and/or 2)
• Skeletally mature

Exclusion Criteria:

• Skeletally immature
• Previous ipsilateral ankle surgery
• Bilateral ankle fractures or other major injuries that would affect recovery time
• Grade 3 open fractures
• Inability to co-operate with post-op protocol (advanced dementia, polytrauma patient)
• Non-ambulatory pre injury
• Tibial plafond fractures including articular impaction requiring elevation
• Syndesmosis injury requiring fixation
• Posterior Malleolus fracture - more than 25% of articular surface