1. Weight-bearing in ankle fractures: An audit of UK practice
- Author
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Rizwan Shahid, Chia Yew Y. Kong, Mohammed Al Mustafa, Kar H. Teoh, Oliver Negus, Farzad Shabani, Khalid Al-Dadah, Kedar Chirputka, Simon Humphry, Mark Blomfield, Suan Khor, Krasimir Nachev, Douglas Evans, Bakir Al-Dulaimy, Vishal Borse, Kimberely Shuttlewood, Antonia Myatt, Rory Cuthbert, Matthew Weston, Thomas J Holme, Shirley Lyle, Bernardo Duarte Brandao, Jo-Ann Bate, Togay Koc, Samantha Hook, Roozbeh Shafafy, Ganesh Prasad, Jagmeet S Bhamra, Ravikanth Mallina, Peter Robinson, Hannah Wilkinson, Sean Duffy, Saad Elashry, Navraj S Nagra, Richard Kapur, Benedict Rogers, Winster D'Souza, Charlotte T Thomas, Charlotte E Cross, Maire-Clare Killen, Shashank Pillai, Jeremy Parker, Arunray Ray, Paul Brewer, Syed Ahmed, Min Soo S.K. Kim, Roberto J.R. Alho, Lucy Walker, Mariam Sattar, Taran Khangura, James Cruickshank, Andrew J. Berg, Govind Singh S. Chauhan, Sean Masterson, Ben A Marson, Emilie Lostis, Mike Karski, Lucy Cassidy, Shreekant Gupta, Robert Payne, Tom Wood, Naeem Dowlut, Mehvish Hayat, Sathish Bala, Sabri Bleibleh, Usman Ahmed, Christopher Goodland, Paul Matthews, Michael Rafferty, Gavin Reynolds, Andreea Lupu, Neil Wickramasinghe, Fady Awad, James Bennett, Poonam Kandel, Charlotte Tunstall, Richard L. Donovan, Sam Nahas, Kalpesh R. Vaghela, Henry A. Claireaux, Seyed Ali, Mike Stoddart, Marieta Franklin, Mike Hughes, Edward Karam, Sangam Malani, Adeel Ikram, Purnajyoti Banerjee, Richard Limb, Jim Barrie, Stanley Masunda, Ryan Wong, Lee Parker, Hartej Sur, Purwa Wilson, Praveen Rai, Shahid Mehmood, Vladislav Kutuzov, Jamie A Nicholson, Mike Petrie, Nithin Unnikrishnan, Anna Kropelnicki, Emma Davies, Abhinav Singh, Tariq Yasin, Latif Mubasher, Arun Nair, George Matheron, Thomas Ankers, Rachael Grupping, Albert Ngu, Feiran Wu, Jonathan Topping, Mustafa Rashid, Ravi Popat, Ravi Badgetu, Niak Puei Koh, John Mcfall, Felicity Auld, Yin Tam, Julia Street, Ling Kho, Shahrier Sarker, Karadi Hari Sunil Kumar, Robert Boyd, Mohamed Elbashir, Jennie Simpson, Gemma Salt, Andrew Hannah, Hayleigh Byrne, Payam Tarassoli, Olatoyosi Williams, Bernard Ferns, Ahsan Akhtar, Manafa Chibuzo, Barbara Frank, Darren Ebreo, Zara Hayat, Quen O. Tang, William Nabulyato, Yuhao Zhang, Sushmith Gowda, Mark Poustie, Singapura Shashidhara, Liam Z Yapp, Richard Unsworth, Frances Andrews, Ernest Chew, Leanne Dupley, Robert Clayton, Tom Murphy, Ady Abdelhaq, Steve Kahane, James T. Bourne, Richard J. Gadd, Edmund Leong, Alastair Marsh, Sheena Seewoonarain, John Jeffery, Sian Sokota, Iosif Pagkalos, Junaid Sayani, Victor West, Ali AlTaweel, Rajkumar Thangaraj, Helen Ribee, David Skipsey, Ghazal Hodhody, Muhammad Adeelakhtar, Matt Gray, Zainab Kazmi, Naeil Lotfi, Sophia Burns, Kevin Syam, Thomas Aitken, Vinoth Ravi, Kathryn Mcloughlin, Luke Render, Ghias Bhattee, Yousufuddin Shaik, Mallikarjun Chandrappa, Raghunaathan Rangan, Ravikiran Shenoy, Kartik Logishetty, Mark Jones, Benjamin Drake, Sheraz S. Malik, George Holland, Femi Thondickal, Christopher Crome, Jack Pearce, David Knowles, Nicola Blucher, Sunil Trakru, Thomas H. Carter, Ganapathy Perianayagam, Alex Goubran, Lucy Maling, Rupert Wharton, Albert Chikate, Jasprit Kaur, Kate Spacey, Alexander Durst, Alina Budacan, Nicholas Edwards, Lawrence S Moulton, Jonathan Quayle, Jo Higgins, Ryan Higgin, Ashley B Scrimshire, Christopher P. Bretherton, Laura Bowen, Anil Sharma, Patrick Williams, Simon F Bellringer, Steven Ross, Ignatius Liew, Sheweidin Aziz, James R. Gill, Dinnish Baskaran, Yiteng Xu, Andraay Leung, Philip Thomas, Parag Raval, Ross Muir, Reza Mansouri, Christopher Fenner, Xavier L. Griffin, Benjamin Barkham, Michael S. Hennessy, Fiona Bintcliffe, Christopher Buckle, John Ferns, Martin Lovell, Shahbaz S. Malik, Barry Rose, Katerina Kyprianou, Julian F. Maempel, Rashid Abu-Rajab, Blair Tweedie, Moritz Lebe, Stephen Ng Man Sun, Subra Nathan, Piyush Mahapatra, Raviraj Kugapiriyan, Lily Li, Islam Sarhan, Rishi Das, James Davenport, Surjit Lidder, Ross A. Fawdington, and Collaborative, BONE
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Adult ,Male ,Syndesmosis ,medicine.medical_specialty ,Time Factors ,Adolescent ,Nice ,Audit ,Ankle Fractures ,medicine.disease_cause ,law.invention ,Weight-bearing ,Nice guidance ,Weight-Bearing ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Prospective Studies ,Podiatry ,Aged ,computer.programming_language ,Aged, 80 and over ,030222 orthopedics ,business.industry ,Patient Selection ,Recovery of Function ,030229 sport sciences ,Middle Aged ,Malleolus ,United Kingdom ,Treatment Outcome ,medicine.anatomical_structure ,Physical therapy ,Female ,Ankle ,business ,computer - Abstract
Introduction: The purpose of this national study was to audit the weight-bearing practice of orthopaedic services in the National Health Service (NHS) in the treatment of operatively and non-operatively treated ankle fractures. Methods: A multicentre prospective two-week audit of all adult ankle fractures was conducted between July 3rd 2017 and July 17th 2017. Fractures were classified using the AO/OTA classification. Fractures fixed with syndesmosis screws or unstable fractures (>1 malleolus fractured or talar shift present) treated conservatively were excluded. No outcome data were collected. In line with NICE (The National Institute for Health and Care Excellence) criteria, “early” weight-bearing was defined as unrestricted weight-bearing on the affected leg within 3 weeks of injury or surgery and “delayed” weight-bearing as unrestricted weight-bearing permitted after 3 weeks. Results: 251 collaborators from 81 NHS hospitals collected data: 531 patients were managed non-operatively and 276 operatively. The mean age was 52.6 years and 50.5 respectively. 81% of non-operatively managed patients were instructed for early weight-bearing as recommended by NICE. In contrast, only 21% of operatively managed patients were instructed for early weight-bearing. Discussion: The majority of patients with uni-malleolar ankle fractures which are managed non-operatively are treated in accordance with NICE guidance. There is notable variability amongst and within NHS hospitals in the weight-bearing instructions given to patients with operatively managed ankle fractures. Conclusion: This study demonstrates community equipoise and suggests that the randomized study to determine the most effective strategy for postoperative weight-bearing in ankle fractures described in the NICE research recommendation is feasible.
- Published
- 2019
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