{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T13:52:12Z","timestamp":1791208332928,"version":"4.1.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,5]]},"abstract":"\n OBJECTIVES:<\/jats:title>\n To compare outcomes of early weight bearing (EWB) at 2-weeks versus delayed weight bearing (DWB) at 6-weeks following operative ankle fracture fixation with syndesmotic stabilization.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Design: Prospective randomized controlled clinical trial<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Single Level 1 Trauma Center<\/jats:p>\n <\/jats:sec>\n \n Patient Selection Criteria:<\/jats:title>\n Adult patients with operative rotational ankle fractures (OTA\/AO 44A-C) and an intraoperative finding of syndesmotic injury following fracture fixation between September 2019 and September 2022 were included. All underwent dynamic syndesmotic stabilization utilizing a single suture button. Exclusion criteria were fibular fractures not amenable to length-stable fixation (e.g., Maisonneuve injuries), neuropathic diabetes, body weight \u2265147.4 kg (325 lbs), imprisonment, pregnancy, lactation, end-stage renal disease, cognitive dysfunction, or polytrauma.<\/jats:p>\n <\/jats:sec>\n \n Outcome Measures and Comparisons:<\/jats:title>\n Maintenance of syndesmotic reduction at 1 year comparing immediate postoperative and 1-year CT scans of both ankles was the primary outcome. Secondary outcomes: pain (VAS), surgical satisfaction (SSQ-8), functional scores (AAOS Foot and Ankle), ankle range of motion, and complications.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n 106 patients were enrolled: 40 underwent syndesmotic fixation and were randomized. 16 patients (mean age 41 (21-80), 9 female, 7 male) randomized to EWB and 23 (mean age 43 (23-85), 12 female, 11 male) to DWB completed the study. Fracture types included lateral malleolar (OTA\/AO 44A), bimalleolar and bimalleolar equivalent (OTA\/AO 44B), and trimalleolar (OTA\/AO 44C) fractures, with similar distribution between groups (p=0.96). EWB group had significantly higher pain scores (4.6 \u00b1 2.8 vs 2.8 \u00b1 2.3, p = 0.039) at the 2-week visit compared to DWB. At 1 year, dorsiflexion in the EWB group was significantly higher (14.2\u00b0 \u00b1 3.9\u00b0 vs 7.7\u00b0 \u00b1 4.4\u00b0) than the DWB (p = 0.017). No significant difference in syndesmotic malreduction (p>0.99), loss of reduction (p>0.89), PROs, development of arthritis (p>1.0) or complication rates (p>0.37) at any other timepoint.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Early weight bearing at 2-weeks was noninferior to delayed weight bearing at 6-weeks following rotational ankle fracture fixation with a syndesmotic injury stabilized with flexible fixation.<\/jats:p>\n <\/jats:sec>\n \n LEVEL OF EVIDENCE:<\/jats:title>\n Level I<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000003296","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T13:00:17Z","timestamp":1791205217000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes Following Early Weight Bearing in Syndesmotic Injuries: A Randomized Controlled Trial"],"prefix":"10.1097","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7579-8405","authenticated-orcid":false,"given":"Mubinah","family":"Khaleel","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, University of Missouri \u2013 Columbia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4717-123X","authenticated-orcid":false,"given":"Elizabeth","family":"Durante","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Missouri \u2013 Columbia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Missouri \u2013 Columbia School of Medicine."},{"name":"University of Missouri \u2013 Columbia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8467-6494","authenticated-orcid":false,"given":"James P.","family":"Stannard","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Missouri \u2013 Columbia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Della Rocca","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Missouri \u2013 Columbia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3340-1156","authenticated-orcid":false,"given":"Brett","family":"Crist","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Missouri \u2013 Columbia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0862-995X","authenticated-orcid":false,"given":"James L.","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Missouri \u2013 Columbia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6848-1670","authenticated-orcid":false,"given":"Kyle","family":"Schweser","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Missouri \u2013 Columbia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/BOT.0000000000003296","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T13:00:18Z","timestamp":1791205218000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/BOT.0000000000003296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000003296","relation":{},"ISSN":["0890-5339","1531-2291"],"issn-type":[{"value":"0890-5339","type":"print"},{"value":"1531-2291","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]}}}