Predicting Ankle Fracture Outcomes: Insights from a Prospective Study

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March’s Five Minute Manager

Prediction of Outcome After Ankle Fracture



Prospective inception cohort study investigating 4 factors on outcome following ankle fracture:

  1. Age
  2. Fracture Classification
  3. Management; i.e Surgical/Conservative
  4. Ankle Dorsiflexion Range


Outcome measures were used: 1. OMAS, Olerud and Molander ankle score; 2, LEFS, Lower Extremity Functional Ankle Scale; & 3. GPE, Global Perceived Effect.




62 consecutive patients seen in 2 orthopaedic clinics following ankle fracture at the time of cast removal.



Fracture classification was a statistically significant univariate predictor on the three outcome measures used.

Ankle dorsiflexion measured at the time of cast removal was also a statistically significant predictor of outcome on all three.

Fracture management (surgical or nonsurgical) was predictive of outcome on 1 of the 3.

Age was not predictive of outcome at 6 months for any of the outcome measures used

“This study demonstrates that both initial dorsiflexion range of motion and fracture classification are consistent predictors of disability, perceived improvement, and ankle dorsiflexion range of motion 6 weeks and 6 months after cast removal for ankle fractures. Fracture management (surgical or nonsurgical) is weakly predictive of outcome and age does not predict outcome after ankle fracture.”



By extension this study illustrates the value in early ankle mobilisation following fracture on short and long term outcomes. In our experience, the sooner the better.

Hope this helps! Looking forward to seeing you soon!


Michael Rafla
Australian Sports Physiotherapy
Ivanhoe, Heidelberg, Coburg, Northcote, Carlton North
0431 271 714


Hancock, M. J., Herbert, R. D., & Stewart, M. (2005). Prediction of outcome after ankle fracture. Journal of Orthopaedic & Sports Physical Therapy, 35(12), 786-792.

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