Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort Study
Background: Ankle fractures are common and frequently managed with open reduction and internal fixation (ORIF). Although these fractures can occur at any age, they are most common in younger individuals with high-energy trauma or older adults with lower-energy trauma. Our investigation focused on th...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-04-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/24730114221091806 |
| _version_ | 1797685889429667840 |
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| author | Ailar Ramadi PT, PhD Lauren A. Beaupre PT, PhD Luke Heinrichs MD M. Elizabeth Pedersen MD, MSc |
| author_facet | Ailar Ramadi PT, PhD Lauren A. Beaupre PT, PhD Luke Heinrichs MD M. Elizabeth Pedersen MD, MSc |
| author_sort | Ailar Ramadi PT, PhD |
| collection | DOAJ |
| description | Background: Ankle fractures are common and frequently managed with open reduction and internal fixation (ORIF). Although these fractures can occur at any age, they are most common in younger individuals with high-energy trauma or older adults with lower-energy trauma. Our investigation focused on those aged 65 years or younger. Our primary objective was to describe recovery over the first postfracture year in (1) functional dorsiflexion using the weightbearing lunge test (WBLT), (2) patient-reported functional outcomes using the Olerud Molander Ankle Score (OMAS), (3) return to prefracture activity levels, and (4) return to work. Secondarily, we examined patient and clinical factors (including the WBLT and OMAS) associated with return to prefracture activities, including sports. Methods: Using a prospective inception cohort of 142 patients between 18 and 65 years old who underwent ORIF after ankle fracture and attended follow-up visits, we collected information from participants and their medical charts. We assessed functional dorsiflexion (using side-to-side difference in WBLT), patient-reported functional outcome (OMAS), and self-reported return to prefracture activity levels and work at 6 weeks, 6 months and 1 year postoperatively. Results: The WBLT, OMAS, and return to prefracture activity and work improved significantly over time ( P < .001). However, at 1 year postoperation, the mean side-to-side difference in the WBLT was 3.22±2.68 cm, 69 (72%) reported ankle stiffness, and only 49 (52%) had returned to prefracture activity levels. Of those who were working, 97% had returned to work by 1 year postoperation. Only the OMAS ( P < .001) and side-to-side difference in WBLT ( P = .011) were significantly associated with return to prefracture activity levels. Conclusion: Although participants improved significantly over the first postoperative year in all outcomes, many reported limitations in functional dorsiflexion and return to prefracture activities. Those with higher OMAS scores and smaller side-to-side difference in WBLT were more likely to return to prefracture activity levels by 1 year postoperatively. Level of Evidence: Level II, prognostic study. |
| first_indexed | 2024-03-12T00:57:50Z |
| format | Article |
| id | doaj.art-2108ed8492614ee0b682989cbbe07510 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-03-12T00:57:50Z |
| publishDate | 2022-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-2108ed8492614ee0b682989cbbe075102023-09-14T12:04:55ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142022-04-01710.1177/24730114221091806Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort StudyAilar Ramadi PT, PhD0Lauren A. Beaupre PT, PhD1Luke Heinrichs MD2M. Elizabeth Pedersen MD, MSc3Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, CanadaDivision of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaDivision of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaDivision of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaBackground: Ankle fractures are common and frequently managed with open reduction and internal fixation (ORIF). Although these fractures can occur at any age, they are most common in younger individuals with high-energy trauma or older adults with lower-energy trauma. Our investigation focused on those aged 65 years or younger. Our primary objective was to describe recovery over the first postfracture year in (1) functional dorsiflexion using the weightbearing lunge test (WBLT), (2) patient-reported functional outcomes using the Olerud Molander Ankle Score (OMAS), (3) return to prefracture activity levels, and (4) return to work. Secondarily, we examined patient and clinical factors (including the WBLT and OMAS) associated with return to prefracture activities, including sports. Methods: Using a prospective inception cohort of 142 patients between 18 and 65 years old who underwent ORIF after ankle fracture and attended follow-up visits, we collected information from participants and their medical charts. We assessed functional dorsiflexion (using side-to-side difference in WBLT), patient-reported functional outcome (OMAS), and self-reported return to prefracture activity levels and work at 6 weeks, 6 months and 1 year postoperatively. Results: The WBLT, OMAS, and return to prefracture activity and work improved significantly over time ( P < .001). However, at 1 year postoperation, the mean side-to-side difference in the WBLT was 3.22±2.68 cm, 69 (72%) reported ankle stiffness, and only 49 (52%) had returned to prefracture activity levels. Of those who were working, 97% had returned to work by 1 year postoperation. Only the OMAS ( P < .001) and side-to-side difference in WBLT ( P = .011) were significantly associated with return to prefracture activity levels. Conclusion: Although participants improved significantly over the first postoperative year in all outcomes, many reported limitations in functional dorsiflexion and return to prefracture activities. Those with higher OMAS scores and smaller side-to-side difference in WBLT were more likely to return to prefracture activity levels by 1 year postoperatively. Level of Evidence: Level II, prognostic study.https://doi.org/10.1177/24730114221091806 |
| spellingShingle | Ailar Ramadi PT, PhD Lauren A. Beaupre PT, PhD Luke Heinrichs MD M. Elizabeth Pedersen MD, MSc Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort Study Foot & Ankle Orthopaedics |
| title | Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort Study |
| title_full | Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort Study |
| title_fullStr | Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort Study |
| title_full_unstemmed | Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort Study |
| title_short | Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort Study |
| title_sort | recovery and return to activity 1 year after ankle fracture managed with open reduction and internal fixation a prospective longitudinal cohort study |
| url | https://doi.org/10.1177/24730114221091806 |
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