Bi-trimalleolar Fracture and APOS System Treatment (APOS-IL 001)

APOS System Effects in Post-operation Bi-trimalleolar Fracture of Ankle Prospective, Comparative Randomize Trial Study

The purpose of this study is to evaluate of functional tests and clinical findings with APOS System treatment in patient after bi-trimalleolar fracture of ankle. These functional changes will be evaluated AOFS, FAOS, SF36 and WOMAC scores, walking laboratory GAITRite and clinical examination.

Trial design Prospective, comparative, randomize trial. The patients after surgery due to bi or trimalleolar fracture of ankle, that were referred to the physiotherapy treatment, 3 weeks cast and 6 weeks from surgery with full weight bearing indicated by orthopedic The population will randomized separated in trail and control group/ Both receive APOS shoes The trial group will receive APOS walking system The control group will receive the same walking protocol as the trial group without biomechanics units. st visit: enrollment of patient - 6 weeks post op 1. The patient will be given a full verbal and written explanation regarding the trial and treatment. The patient will sign the informed consent form and will be given a serial number. 2. The screening forms will be completed. 3. Demographic data: date of birth, sex, age and complete medical history, height and previous treatments will be recorded. 4. Physical examination: range of motion, Achilles tendon thickness. The results will be recorded in the CRF 5. Walking test using a laboratory walking GAITRite + 6 minute walk test 6. Fill out questionnaire: FAOS - AOSF - SF36 - WOMAC 7. Adjustment of Apos walking System 2nd visit: 12 weeks post op Physical examination: range of motion, Achilles tendon thickness. The results will be recorded in the CRF Walking test using a laboratory walking GAITRite + 6 minute walk test Fill out questionnaire: FAOS - AOSF - SF36 - WOMAC 3rd visit: 3 month post op Physical examination: range of motion, Achilles tendon thickness. The results will be recorded in the CRF Walking test using a laboratory walking GAITRite + 6 minute walk test Fill out questionnaire: FAOS - AOSF - SF36 - WOMAC 4th visit: 6 month post op Physical examination: range of motion, Achilles tendon thickness. The results will be recorded in the CRF Walking test using a laboratory walking GAITRite + 6 minute walk test Fill out questionnaire: FAOS - AOSF - SF36 - WOMAC 5th visit: 12 month post op 1. Physical examination: range of motion, Achilles tendon thickness. The results will be recorded in the CRF 2. Walking test using a laboratory walking GAITRite + 6 minute walk test 3. Fill out questionnaire: FAOS - AOSF - SF36 - WOMAC 6th visit: 18 month post op Physical examination: range of motion, Achilles tendon thickness. The results will be recorded in the CRF Walking test using a laboratory walking GAITRite + 6 minute walk test Fill out questionnaire: FAOS - AOSF - SF36 - WOMAC 7th visit: 24 month post op Physical examination: range of motion, Achilles tendon thickness. The results will be recorded in the CRF Walking test using a laboratory walking GAITRite + 6 minute walk test Fill out questionnaire: FAOS - AOSF - SF36 - WOMAC

The trial group will receive APOS walking system The control group will receive the same walking protocol as the trial group without biomechanics units

The control group will receive the same walking protocol as the trial group without biomechanics units

Evaluate with functional tests and clinical findings patient after bi-trimalleolar fracture of ankle with who recive APOS System treatment. Functional changes will be evaluated using FAOS, SF36 and WOMAC scores, walking laboratory GAITRite and clinical examination.

Inclusion Criteria: Male or female patients 18-65 year old Post operation bi- trimalleolar fracture of ankle Download cast after 3 weeks Full Weight bearing after 6 weeks Patients in medical condition to receive physiotherapy treatment Patients who are willing to participate in the trial, to come to all scheduled visits and to sign the informed consent forms. Exclusion Criteria: Patients suffering muscular or nerve disorders Patients who are unable to use the APOS SYSTEM and can not complete the experimental protocol due to physical or mental handicap Non cooperative patient with the basic rehab program.

Segal G, Elbaz A, Parsi A, Heller Z, Palmanovich E, Nyska M, Feldbrin Z, Kish B. Clinical outcomes following ankle fracture: a cross-sectional observational study. J Foot Ankle Res. 2014 Nov 28;7(1):50. doi: 10.1186/s13047-014-0050-9. eCollection 2014.