Early weight bearing after ORIF for trimalleolar ankle fractures may be a safe option
Researchers saw no differences in union rate, infection, implant failure or return to the OR between patients operatively treated for trimalleolar ankle fractures who were assigned to early weight bearing vs. late weight bearing.
Devon M. Myers, DO, and colleagues from OhioHealth Grant Medical Center in Columbus, Ohio, performed a retrospective review of data from 185 patients who underwent surgical stabilization for trimalleolar ankle fractures. Forty-seven patients received management with early weight bearing (EWB) – defined as 3 weeks or less after surgery – and 138 patients received management with late weight bearing (LWB), defined as more than 3 weeks after surgery.
According to the study, outcomes measures included fracture union, implant failure, complications, ambulatory status, infection rate and return to surgery.
One nonunion (2.1%) occurred in the EWB group and 6 nonunions (4.3%) occurred in the LWB group. Additionally, the researchers found no differences in infection, implant failure or return to surgery. Myers and colleagues also noted deep infection and open fracture decreased union rate, while syndesmotic fixation increased union rate.
“EWB at 3 weeks or less postoperatively appears to be safe for patients with trimalleolar ankle fractures,” the researchers wrote in the study. “This information may allow orthopedic surgeons to safely mobilize patients early after trimalleolar ankle fractures without concern for increased complication rates,” they added.