SLR - February 2012 - Omair Zafar
Reference: Kimmel LA, Edwards ER, Liew SM, Oldmeadow LB, Webb MJ, Holland AE, Injury 2011, sept 29, 2011 (ePub ahead of print).
Scientific Literature Review
Reviewer: Omair Zafar, DPM
Residency Program: Detroit Medical Center
Podiatric Relevance:
Bed rest with elevation of the affected limb is commonly prescribed postoperatively following ankle fracture fixation although there is no evidence that this is necessary.
Methods:
A total of 104 patients underwent ORIF of an ankle fracture at The Alfred Hospital, Melbourne, Australia between July 2008 and January 2010. The patients were randomly chosen to be in either the early mobilization group (first day post surgery) or control group (bed rest with elevation until day 2 post surgery).
Results:
Wound breakdown rate was 2.9% (3 patients in the control group). Median length of stay of the early mobilization group was 55hrs compared with 71hrs in the control group (p < 0.0001). Opioid use for the control group was an average of 90mg morphine equivalent versus the 67 mg morphine equivalent for the early mobilization group (p = 0.32).
Conclusions:
This study indicates that early mobilization following surgical fixation of an ankle fracture results in a shorter hospital stay without evidence of an increased risk of re-admission or wound complication.