Displaced ankle fractures treated surgically and postoperative management.

Ankle fractures are common in young adults, often resulting from athletic activities. They can be subdivided into stable and unstable fractures. The unstable fracture consists of bone or a combined bone and ligamentous injury. In an unstable fracture the talus is displaced 2 mm or more and open reduction with internal fixation is recommended. Good functional results depend on three factors--anatomic restoration of the articulating surfaces, early range of motion, and early weight bearing. The role of early weight bearing is emphasized as a significant factor in contributing to good functional results. Based on our clinical experience with the nonathletic patient, 10 degrees of dorsiflexion is required for normal activities. Dorsiflexion has been noted to be a significant movement, and its limitation causes more disability than limited plantar flexion. A below-knee orthosis was described that enables the patient to ambulate and exercise dorsiflexion and plantar flexion, minimizing rotational forces acting on the ankle.