Gait Analysis Evaluation of Early Weight-Bearing After Surgical Fixation of Ankle Fractures: A Prospective Observational Study.

AIM: Post-operative weight-bearing strategies after surgical fixation of ankle fractures remain controversial. This prospective observational pilot study aimed to evaluate whether an early weight-bearing (EWB) protocol influences weight-bearing symmetry during static stance and clinical and functional recovery compared with a restricted weight-bearing protocol.

METHODS

Thirty-three patients undergoing surgical fixation for ankle fractures were allocated to either EWB (n = 17) or restricted weight-bearing (RWB) (n = 16) according to surgeon preference and fracture characteristics. Clinical, radiographic, and gait analysis outcomes were assessed at 6 weeks, 3 months, and 6 months postoperatively. The primary outcome was weight-bearing symmetry during bipodalic static stance. Secondary outcomes included subjective return to balance, independence in activities of daily living (ADL), and return to work. Data were analyzed using nonparametric tests.

RESULTS

At 6 weeks, the EWB group demonstrated significantly greater weight-bearing symmetry during static stance compared to the RWB group (eyes open, p = 0.048; eyes closed, p = 0.044). Patients in the EWB group also showed higher rates of subjective return to balance (76% vs 31%, p = 0.009) and ADL independence (82% vs 50%, p = 0.049). No significant differences were observed in return to work (p = 0.805). No complications were observed in either group.

CONCLUSIONS

In this small observational cohort, early weight-bearing was associated with improved early weight-bearing symmetry and functional recovery without observed complications. These findings should be interpreted cautiously, due to the study design and sample size and require confirmation in larger controlled studies.