Functional Outcomes Following Ankle Fracture Fixation: A Southeast Asian Series in a Tertiary Care Hospital
- 1Orthopaedic Surgery, Changi General Hospital, Singapore, SGP
Abstract
Introduction Early mobilization following ankle fracture open reduction and internal fixation (ORIF) improves long-term patient functionality. Targeted staged training is mainly focused on minimizing long-term joint stiffness. In this study, we prospectively monitored how ankle range of motion (ROM), active and passive, progresses in the postoperative period. Methods This was a prospective, observational study on patients undergoing ORIF of ankle fractures by a single surgeon between 2024 and 2025 at Changi General Hospital, Singapore. We collected ankle ROM measurements, both active and passive, at the 6-week, 8-week, and 12-week postoperative visits. ROM of the ankle was measured by a Jamar E-Z Read goniometer. Analysis of variance (ANOVA) and Bonferroni post-hoc analysis were used to examine statistical differences in ankle ROMs over time. Results A total of 28 patients were enrolled. After initial attrition, 23 patients were assessed, and due to a further loss to follow-up of seven patients, 16 completed the study and were analyzed. Serial goniometric measurements demonstrated a statistically significant improvement across 12 weeks in total active range of motion (ROM) from 29.90° ± 8.53° at 6 weeks to 38.17° ± 9.51° at 12 weeks (p= 0.020, partial eta squared = 0.229) and total passive ROM from 38.19° ± 10.48° at 6 weeks to 47.56° ± 10.40° at 12 weeks (p= 0.014, partial eta squared = 0.249). Conversely, active lag--representing the discrepancy between passive and active motion arcs--showed no statistically significant change over time (6 weeks: 8.29° ± 5.59° vs. 12 weeks: 9.39° ± 5.56°; p = 0.384, partial eta squared = 0.062), indicating persistent motor inhibition or weakness relative to joint stiffness resolution. Conclusion Our study demonstrates that while operative fixation of ankle fractures yields significant structural recovery and passive joint flexibility over 12 weeks, an active motion lag persists. This plateau in active lag suggests that early postoperative stiffness resolution outpaces neuromuscular recovery, highlighting a clinical rationale for future prospective studies to investigate strategies aimed at optimizing active functional recovery.
Related
- Predictors of Functional Recovery Following Primary Ilizarov External Fixation in Compound Distal Third Tibial Fractures
- Functional Trajectories Following Clinically Selected Management of Concomitant Proximal Humerus Fractures in Geriatric Hip-Fracture Patients: A Retrospective Cohort Study
- Effects of different anti-osteoporosis medications on re-fracture risk, bone mineral density, and functional recovery following hip fragility fracture surgery: a systematic review and network meta-analysis
- Association of Coronoid Height Loss with Functional Outcomes in Terrible Triad Injuries Treated Using a Selective Fixation Algorithm
- Functional Recovery Trajectory of Temporomandibular Joint Following Condylar Fracture Treated by Closed Reduction and Intermittent Jaw Mobilization: A Longitudinal Assessment Using Helkimo’s Clinical Dysfunction Index
BibTeX
@article{cen2026functional,
title = {{Functional Outcomes Following Ankle Fracture Fixation: A Southeast Asian Series in a Tertiary Care Hospital}},
author = {Gennie Lim Yan Cen and Noman Ali and Don Koh and Ing How Moo and Charles Kon Kam King},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117399},
url = {https://europepmc.org/article/PMC/PMC13726792},
note = {CC BY},
}
RIS
TY - JOUR
TI - Functional Outcomes Following Ankle Fracture Fixation: A Southeast Asian Series in a Tertiary Care Hospital
AU - Gennie Lim Yan Cen
AU - Noman Ali
AU - Don Koh
AU - Ing How Moo
AU - Charles Kon Kam King
PY - 2026
DA - 2026/10/03
JO - Cureus
DO - 10.7759/cureus.117399
UR - https://europepmc.org/article/PMC/PMC13726792
AB - Introduction Early mobilization following ankle fracture open reduction and internal fixation (ORIF) improves long-term patient functionality. Targeted staged training is mainly focused on minimizing long-term joint stiffness. In this study, we prospectively monitored how ankle range of motion (ROM), active and passive, progresses in the postoperative period. Methods This was a prospective, observational study on patients undergoing ORIF of ankle fractures by a single surgeon between 2024 and 2025 at Changi General Hospital, Singapore. We collected ankle ROM measurements, both active and passive, at the 6-week, 8-week, and 12-week postoperative visits. ROM of the ankle was measured by a Jamar E-Z Read goniometer. Analysis of variance (ANOVA) and Bonferroni post-hoc analysis were used to examine statistical differences in ankle ROMs over time. Results A total of 28 patients were enrolled. After initial attrition, 23 patients were assessed, and due to a further loss to follow-up of seven patients, 16 completed the study and were analyzed. Serial goniometric measurements demonstrated a statistically significant improvement across 12 weeks in total active range of motion (ROM) from 29.90° ± 8.53° at 6 weeks to 38.17° ± 9.51° at 12 weeks (p= 0.020, partial eta squared = 0.229) and total passive ROM from 38.19° ± 10.48° at 6 weeks to 47.56° ± 10.40° at 12 weeks (p= 0.014, partial eta squared = 0.249). Conversely, active lag--representing the discrepancy between passive and active motion arcs--showed no statistically significant change over time (6 weeks: 8.29° ± 5.59° vs. 12 weeks: 9.39° ± 5.56°; p = 0.384, partial eta squared = 0.062), indicating persistent motor inhibition or weakness relative to joint stiffness resolution. Conclusion Our study demonstrates that while operative fixation of ankle fractures yields significant structural recovery and passive joint flexibility over 12 weeks, an active motion lag persists. This plateau in active lag suggests that early postoperative stiffness resolution outpaces neuromuscular recovery, highlighting a clinical rationale for future prospective studies to investigate strategies aimed at optimizing active functional recovery.
SN - 2168-8184
ER -