Effect of early weight bearing on rehabilitation in ankle fractures with syndesmotic injuries

To explore the effect of different weight-bearing timings on the rehabilitation of ankle fractures with syndesmotic injuries. Based on different postoperative rehabilitation protocols, the patients were divided into early weight-bearing groups (EWB groups) and late weight-bearing groups (LWB groups). The Olerud-Molander Ankle Score (OMAS), Visual Analog Scale (VAS) pain score, range of motion (ROM), time to return to work, time to return to sports, wound complications, and fracture fixation complications were recorded and compared between the groups. A total of 81 patients completed the follow-up, with an overall follow-up period of 12 months. At 6 weeks post-surgery, the EWB group had significantly higher OMAS scores than the LWB group (P < 0.01). The EWB group also had lower VAS pain scores at 6 weeks compared to the LWB group (P < 0.01). At 6 and 12 weeks, the EWB group exhibited significantly higher ROM than the LWB group (both P < 0.01). The EWB group returned to work and sports significantly earlier than the LWB group (P = 0.01, 0.04). This study shows that early weight bearing initiated 2 weeks post-surgery is safe and feasible in patients sustaining ankle fractures with syndesmotic injuries.