[Is functional conservative treatment of stable lateral ankle fractures justified?].
For Weber type B ankle fractures, operative treatment is generally recommended. Yet, there is no general agreement about the role of functional treatment. In a prospective follow-up study from December 1990 to May 1994, 146 patients were reviewed. The mean follow-up time was 17.3 months for clinical examinations and 19.6 months for X-rays. There were no failures. In all, 85 patients (58%) were treated conservatively (group K). A below-the-knee plaster was applied to 23 patients for 6 weeks, and 62 patients had functional treatment with an ankle brace. According to the Olerud Score, the first subgroup (K-plaster) achieved 89.4 points and the last (K-func.) reached 95.7 points. There were no signs of post-traumatic arthritis. 61 patients (42%) had open reduction and internal osteosynthesis (group OP). In 19 patients a plaster immobilization was necessary, and in 42 patients early mobilization was possible. The first subgroup (OP-plaster) achieved 85.0 points in the Olerud Score; the last (OP-func.) achieved 92.4 points. According to the degree of instability following ankle injuries, a new algorithm for treatment of type B ankle fractures is described, emphasizing early mobilization and functional after treatment.
Richter
J
J
Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliche Kliniken Bergmannsheil Bochum.
Langer
C
C
Hahn
M P
MP
Josten
C
C
Muhr
G
G
D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D002370:Casts, Surgical; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000534:rehabilitation; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology
Ist die funktionell konservative Behandlung stabiler Aussenknöchelfrakturen gerechtfertigt?