SRS116 - Does early mobilisation and early weight bearing of surgically operated ankle fractures improve return to work and socioeconomic outcomes?

Introduction Ankle fractures are a common orthopaedic injury with substantial socioeconomic implications, particularly regarding delayed return to work (RTW). This literature review aims to identify if early mobilisation and weight bearing (EM/WB) following surgical fixation improves RTW times and broader socioeconomic outcomes compared to traditional immobilisation. Establishing such evidence-based rehabilitation protocols is crucial for optimising patient recovery and reducing societal costs. Methodology A critical appraisal of the current literature was conducted, focusing on high-quality evidence including multicentre randomised controlled trials and prospective studies. The analysis compared EM/WB protocols with delayed weight bearing, evaluating key outcomes including functional scores (OMAS, AOFAS), time to RTW, direct healthcare costs and indirect societal costs. Results The evidence consistently demonstrated that EM/WB protocols lead to superior functional recovery, with significantly higher functional scores observed within the first 6–12 weeks post-operation. Critically, patients in EM/WB groups returned to work approximately 3–5 weeks earlier on average. Socioeconomic analyses reveal that EM/WB is cost-effective, generating significant healthcare savings (for example mean savings of £722 per patient in one study) and reducing productivity losses by facilitating faster occupational reintegration. Conclusions The findings support a paradigm shift towards EM/WB as the standard of care, highlighting its dual benefit in enhancing patient recovery and providing economic advantages. Future research should prioritise large-scale, long-term studies with standardised EM/WB definitions and explore patient specific factors to guide personalised rehabilitation strategies, ensuring optimal outcomes for all individuals.