78 - Freie Mitteilung
16. Mai 2019, 17:30 - 19:00, Sopra 3, 4. OG
Single-leg balance performance after surgical versus conservative treatment of ankle fractures – Preliminary results
C. Nüesch, K. Byrnes, V. Iten, N. Bürgin, M. Horisberger, F. Saxer, A. Mündermann, Presenter: C. Nüesch (Basel)
Ankle fractures type Weber B1 can be treated either surgically or conservatively. The objective of this study was to investigate if single-leg balance performance 1 year after Weber B1 ankle fracture differs between patients treated surgically or conservatively and healthy controls.
Single-leg balance performance was assessed in six patients after operative treatment (5 male; age, 57.8 +/- 23.2 years; body mass index (BMI), 25.0 +/- 5.2 kg/m2), five patients after conservative treatment (4 male; age, 57.6 +/- 9.5 years; BMI, 27.4 +/- 7.2 kg/m2), and seven healthy control subjects (4 male; age, 40.4 +/- 18.7 years; BMI 21.5 +/- 1.2 kg/m2). Participants were instructed to stand on a force plate (Kistler, 2400 Hz) for 30s on one leg with arms akimbo and the other knee flexed at 90°. For the first 15s (or until the first foot contact) the length of the center of pressure (COP) path and mean mediolateral and anteroposterior COP velocity were calculated. If the single leg stance time was smaller than 15s, COP path length was extrapolated to 15s. Additionally, the subjective outcome was assessed using the Foot and Ankle Outcome Score (FAOS). Differences between groups were analyzed using independent t-tests (P<0.05).
Both patient groups rated their foot related quality of life lower than the control group (operative: 77 +/- 11; conservative: 85 +/- 7; control: 98 +/- 4; P<0.001, P=0.012). Three patients with conservative treatment (1 both, 1 injured, 1 contralateral side) and two patients with operative treatment (both sides) could not complete 15s of single leg stance. Those who were able to balance longer on one leg had higher FAOS Sport subscores (R=0.549, P=0.018). Patients treated conservatively had greater COP velocity in anterior-posterior direction in the injured leg than healthy subjects (95% confidence interval [1.0; 33.1] mm/s; P=0.039).
Almost half of the patients (45%) had impaired single leg balance in either one or both legs and could not complete the 15s task. The preliminary analysis showed poorer balance performance in patients treated conservatively than operatively and that balance is important for function during sport and recreational activities. If these results are confirmed in a larger cohort, rehabilitation protocols especially after conservative treatment should be modified to include more specific balance training.