Recovery and Return to Activity 1 Year After Ankle Fracture Managed With Open Reduction and Internal Fixation: A Prospective Longitudinal Cohort Study
Bibliographic record
Abstract
Background: Ankle fractures are common and frequently managed with open reduction and internal fixation (ORIF). Although these fractures can occur at any age, they are most common in younger individuals with high-energy trauma or older adults with lower-energy trauma. Our investigation focused on those aged 65 years or younger. Our primary objective was to describe recovery over the first postfracture year in (1) functional dorsiflexion using the weightbearing lunge test (WBLT), (2) patient-reported functional outcomes using the Olerud Molander Ankle Score (OMAS), (3) return to prefracture activity levels, and (4) return to work. Secondarily, we examined patient and clinical factors (including the WBLT and OMAS) associated with return to prefracture activities, including sports. Methods: Using a prospective inception cohort of 142 patients between 18 and 65 years old who underwent ORIF after ankle fracture and attended follow-up visits, we collected information from participants and their medical charts. We assessed functional dorsiflexion (using side-to-side difference in WBLT), patient-reported functional outcome (OMAS), and self-reported return to prefracture activity levels and work at 6 weeks, 6 months and 1 year postoperatively. Results: The WBLT, OMAS, and return to prefracture activity and work improved significantly over time ( P < .001). However, at 1 year postoperation, the mean side-to-side difference in the WBLT was 3.22±2.68 cm, 69 (72%) reported ankle stiffness, and only 49 (52%) had returned to prefracture activity levels. Of those who were working, 97% had returned to work by 1 year postoperation. Only the OMAS ( P < .001) and side-to-side difference in WBLT ( P = .011) were significantly associated with return to prefracture activity levels. Conclusion: Although participants improved significantly over the first postoperative year in all outcomes, many reported limitations in functional dorsiflexion and return to prefracture activities. Those with higher OMAS scores and smaller side-to-side difference in WBLT were more likely to return to prefracture activity levels by 1 year postoperatively. Level of Evidence: Level II, prognostic study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".