Conservative functional treatment of ankle fractures.
Thirty-eight patients (mean age 49 years; range 19-91 years; nine of them over 60 years; 28 women, 10 men) suffering from an isolated Weber B fracture with a dislocation of less than 1 mm underwent functional therapy using a pneumatic ankle brace and were included in a prospective study. The clinical outcome was measured according to the Olerud-Molander ankle score. Functional therapy was finished in 34 cases successfully. Twenty-one patients were scored after 17 months on average (range 8-27 months) with the Olerud-Molander ankle score. A very good result was seen in 18 patients, including 12 with 100 points, a complete remission. The remaining 3 patients showed good results (1 had 90, 2 had 85). However, functional treatment failed in 4 cases due to secondary dislocation. These patients underwent surgery without further complications. The control group, 31 operated patients, did not show as good results. Functional therapy of stable Weber-B ankle fractures appears to be superior to surgery. We were able to avoid surgery in 90% of our patients and got better results than with patients undergoing open reduction and internal fixation.
Dietrich
A
A
Clinic for General, Thoracic and Oncological Surgery, Leipzig University, Liebigstr. 20 a, 04103 Leipzig, Germany. dieta@medizin.uni-leipzig.de
Lill
H
H
Engel
T
T
Schönfelder
M
M
Josten
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D000843:Ankle Joint / Q000503:physiopathology; D001915:Braces; D050723:Fractures, Bone / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome