Complex treatment of ankle stiffness after immobilization

V.E. Ershov, A.V. Krivova, V.P. Zakharov

Tver State Medical University, Tver

Aim: to study the effect of bionic cross-linked hyaluronic acid on the rehabilitation of patients with ankle fractures and clinical manifestations of ankle stiffness after immobilization.

Patients and Methods: the study included 52 patients (mean age 43.9±13.1 years) with ankle fractures of varying degrees after immobilization, who did not undergo surgery. The average immobilization period of the ankle joint was 32.9±5.9 days. The follow-up was carried out for 21 days after the external fixation of the ankle fracture. Main group (n=23) received Flexotron^® CROSS single dose into the ankle joint on the 1st day after immobilization. Control group (n=29) underwent a conventional rehabilitation course without intra-articular administration of hyaluronic acid derivatives.

Results: in the main group, the achievement of the optimal range of motions in the ankle joint (80% of the healthy joint motion range) was observed on average 5.9 days earlier than in the control group (p<0.05), which allowed patients to weight-bear on an injured body part. Improvement in segment function was accompanied by the pain reduction. VAS indicators on the 3rd day of follow-up in the main group were on average 1.9 points lower than in the control group (p<0.05). The achieved analgesic effect and the range of motions in the ankle joint in the main group were persisted throughout the entire follow-up period. No analgesics were taken by the main group, while in the control group, 7 (24%) patients took painkillers "on demand".

Conclusion: the follow-up results indicated a high efficiency of using the bionic cross-linked hyaluronic acid preparation in the complex treatment of contractures after immobilization.

Keywords: ankle fracture, hyaluronic acid, joint contracture, stiffness after immobilization.

For citation: Ershov V.E., Krivova A.V., Zakharov V.P. Complex treatment of ankle stiffness after immobilization. RMJ. 2020;13:28–32.