SLR - November 2023 - Chokshi
Title: Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort StudyReference: Ramadi A, Beaupre LA, Heinrichs L, Pedersen ME. Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort Study. Foot Ankle Orthop. 2022 Apr
Level of Evidence: Level II, prognostic study
Reviewed By: Kirtan Chokshi
Residency Program: East Liverpool City Hospital
Podiatric Relevance: This article should be interesting to a podiatric surgeon because of the parameters that are measured in the article which include long term functional outcomes of patients undergoing open reduction with internal fixation (ORIF) of an ankle fracture with high energy trauma. This article was trying to look at recovery in patients 65 years or younger over the first post-fracture year.
Methods: 142 patients between 18 and 65 years old who underwent ORIF after ankle fracture and attended follow up visits were included; information was collected from participants and their medical charts. Functional dorsiflexion was measured using weight-bearing lunge test (WBLT). Pre-reported functional outcome was measured using Olerud Molander Ankle Score (OMAS). Self-reported return to pre-fracture activity levels and return to work were also measured. The data was collected at 6 weeks, 6 months and 1-year post-operative visits.
Results: Dorsiflexion, functional outcome and self-reported return to pre-fracture activity levels improved significantly over time (P <.001). At 1 year post operation mean side to side difference in the WBLT was 3.22 +/- 2.68cm. A total of 69 patients reported ankle stiffness and 49 patients had returned to pre-fracture activity levels, 97% had returned to work 1 year post operation. Only OMAS and WBLT were significantly associated with return to pre-fracture levels.
Conclusion: The authors concluded that patients undergoing an ORIF of an ankle fracture should anticipate a decrease in their ankle range of motion and full return to pre-fracture activities post operatively. Patients that exhibited a higher WBLT and OMAS scores were more likely to return to their pre-fracture activity level. From this article it can be gathered that patients' activity levels decrease after undergoing an ORIF of an ankle fracture. Even though there is a decrease in activity level, most patients were seen to return to work, at a level of 97%. In the future, when approaching patients who are undergoing an ORIF of their ankle it will allow me to help my patients understand what this procedure entails along with what to expect in regards to long term outcomes.