الفهرس 
Results of immediate versus six weeks delayed weight bearing following bimalleolar ankle fracture fixation
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Abstract
Objective: the aim of this study is to compare results of immediate versus 6 weeks delayed weight bearing following bimalleolar ankle fracture fixation regarding loss of fixation, implant failure, range of motion, complex regional pain syndrome and functional outcome score (The American Orthopedic Foot and Ankle society Score (AOFAS)). Introduction: Ankle fractures represent the most frequent intraarticular fractures to a weight-bearing joint and represent 10% of all fractures. (1) The goals of treatment include achieving sound union of fracture and an ankle that moves and functions normally without pain. (2) The standard of care has generally been non-weight bearing and immobilization in back slab for six weeks following the surgical repair of ankle fractures but this may lead to delayed rehabilitation, limited range of motion and complex regional pain syndrome so, a more contemporary approach utilizes functional bracing and allows for early weight bearing and range of motion. (3,4) Early weight bearing and mobilization is thought to expedite rehabilitation, result in earlier return to function and prevent complications of joint immobilization such as stiffness and muscle atrophy. However, a potential risk of this accelerated protocol is that early weightbearing and/or range of motion may increase the risk of fracture displacement, fixation failure, and/or wound complications. (5) Patient and method:44 patients with bimalleolar ankle fracture were treated operatively and followed up between 9/2020 to 6/2021 and randomly allocated into 2 groups: group A (DWB): for post-operative below knee back slab and they were not allowed to bear weight for 6 weeks. (22 patients) group B (IWB): immediate weight bearing as tolerated on the first postoperative day. (22 patients). All fractures were classified with Lauge-Hansen and Weber classification. Functional results of both groups were evaluated with AOFAS score. All patients were followed up at 2 weeks, 6 weeks, 3 months and 6 months. Results: wound problems were higher in group B (IWB) (one case of superficial infection and one with wound dehiscence), while in group A (DWB) there was one case of superficial infection. CRPS was higher in group A (DWB), 4 cases of which 3 were improved at 6th month follow up, while there were no cases in group B (IWB). No cases of loss of reduction or implant failure in either group at any time point. AOFAS score was superior in the immediate weight bearing group in comparison to delayed weight bearing group at 3 and 6 months and it was statistically significant (p value <0.001)