Journal article
Weight-bearing in ankle fractures: An audit of UK practice
- Abstract:
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Introduction:
The purpose of this national study was to audit the weight-bearing practice of orthopaedic services in the National Health Service (NHS) in the treatment of operatively and non-operatively treated ankle fractures.
Methods:
A multicentre prospective two-week audit of all adult ankle fractures was conducted between July 3rd 2017 and July 17th 2017. Fractures were classified using the AO/OTA classification. Fractures fixed with syndesmosis screws or unstable fractures (>1 malleolus fractured or talar shift present) treated conservatively were excluded. No outcome data were collected. In line with NICE (The National Institute for Health and Care Excellence) criteria, “early” weight-bearing was defined as unrestricted weight-bearing on the affected leg within 3 weeks of injury or surgery and “delayed” weight-bearing as unrestricted weight-bearing permitted after 3 weeks.
Results:
251 collaborators from 81 NHS hospitals collected data: 531 patients were managed non-operatively and 276 operatively. The mean age was 52.6 years and 50.5 respectively. 81% of non-operatively managed patients were instructed for early weight-bearing as recommended by NICE. In contrast, only 21% of operatively managed patients were instructed for early weight-bearing.
Discussion:
The majority of patients with uni-malleolar ankle fractures which are managed non-operatively are treated in accordance with NICE guidance. There is notable variability amongst and within NHS hospitals in the weight-bearing instructions given to patients with operatively managed ankle fractures.
Conclusion:
This study demonstrates community equipoise and suggests that the randomized study to determine the most effective strategy for postoperative weight-bearing in ankle fractures described in the NICE research recommendation is feasible.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Accepted manuscript, pdf, 1.0MB, Terms of use)
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- Publisher copy:
- 10.1016/j.foot.2019.02.005
Authors
- Publisher:
- Elsevier
- Journal:
- Foot More from this journal
- Volume:
- 39
- Pages:
- 28-36
- Publication date:
- 2019-02-14
- Acceptance date:
- 2019-02-10
- DOI:
- EISSN:
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1532-2963
- ISSN:
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0958-2592
- Language:
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English
- Keywords:
- Pubs id:
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pubs:987464
- UUID:
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uuid:c23a1c44-361f-4d77-9399-c5dab7bae089
- Local pid:
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pubs:987464
- Source identifiers:
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987464
- Deposit date:
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2019-04-03
- ARK identifier:
Terms of use
- Copyright holder:
- Elsevier
- Copyright date:
- 2019
- Rights statement:
- © 2019 Elsevier Ltd. All rights reserved.
- Notes:
- This is the accepted manuscript version of the article available. The final version is available online from Elsevier at: https://doi.org/10.1016/j.foot.2019.02.005
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