Title: Passive Dorsiflexion Flexibility after Cast Immobilization for Ankle Fracture
Authors: Elizabeth J. Nightingale, PhD; Anne M. Moseley, PhD; and Robert D. Herbert, PhD.
Source: Clinical Orthopaedics and Related Research. 2006, Dec 14
PODIATRIC RELEVANCE:
Ankle injury is a common pathology seen in the Podiatric profession; therefore discussion on the recovery process after cast removal would be beneficial in post-op recovery for ankle fracture patients.
METHODS:
Ankle fracture is frequently managed with cast immobilization, but immobilization may produce ankle contracture. Ankle flexibility was measured in 150 people recruited with ankle fractures and treated with cast immobilization. Measurements were obtained using an instrumented footplate within 5 days of cast removal and then 4 weeks and 3 months later. Patients were excluded if it was not possible to perform the baseline assessment within 5 days of cast removal also if they had concomitant pathologies, such as symptomatic OA, stroke or other lower limb fractures.
RESULTS:
Recovery of ankle flexibility was incomplete 3 months after cast removal. Both stiffness coefficient and the torque corresponding to the peak dorsiflexion angle at baseline decreased towards normal values during the 3 month recovery period. The mean stiffness coefficient decreased at 4 weeks after cast removal. While the subjects recovering from ankle fractures approached the stiffness and torque values of the able-bodied group, equivalence was never achieved, the mean values had not returned to normal by 3 months. Of relevance, subjects who had surgical fixation following ankle fracture had higher stiffness and preload coefficients and higher torque corresponding to the peak dorsiflexion ankle at baseline than subjects with nonsurgical management. Stiffness, preload and torque were substantially higher at baseline for subjects with surgical fixation.
COMMENTS:
Passive ankle plantarflexion, dorsiflexion flexibility after cast immobilization was documented. Soon after cast removal, passive stiffness and the torque corresponding to the peak dorsiflexion angle at baseline are higher than an able-bodied group, especially with surgical fixation. This increase in stiffness and passive torque decrease over a 3 month period, but full recovery takes longer than 3 months
________________________________________________________________________________________
Disclaimer:
Scientific Abstract Monthly postings are submitted by podiatric surgical residents. The ideas presented are not the opinions of the American College of Foot and Ankle Surgeons (ACFAS), nor are they presented as facts. ACFAS presents this information without any warranty of any kind, expressed or implied, and is not liable for its accuracy nor for any loss or damage caused by the user's reliance on information obtained in these areas.