Early postoperative weight-bearing and muscle activity in patients who have a fracture of the ankle.

Fifty-six patients who had a displaced fracture of the ankle necessitating surgical fixation were randomly assigned to one of three postoperative treatment regimens: no plaster cast or weight-bearing, and active exercises of the ankle; a non-weight-bearing plaster cast; or a plaster walking cast for the first six postoperative weeks. At follow-up with a duration of as much as two years, there were no consistent differences in the clinical results between the three groups. The time lost from work and the proportion of excellent and good clinical results were also uninfluenced by the postoperative regimen. No adverse effects could be detected as a result of the patient's having walked before the syndesmosis screw had been removed. It was concluded that none of the three postoperative regimens has any advantage over the others in a patient who has a stable osteosynthesis of a fracture of the ankle.