What is the Olerud-Molander Ankle Score?
The Olerud-Molander Ankle Score (OMAS) is a brief patient-reported outcomes survey that was built to measure symptom burden following ankle fractures. Comprised of nine questions, this outcome measure can be completed by patients in a few short minutes. Questions cover the patient’s ability to perform a number of activities related to ankle function (i.e., jumping, stairs, etc.), as well as symptom burden, such as swelling and stiffness, and impact on activities of daily living. This survey is generally administered at several timepoints following the initial injury: most commonly at 6-weeks, 3-months, 6-months and 1-year.
How is OMAS Scored?
The scoring of this tool is simple. Each question is scaled differently representing the question’s weight in the overall score. Question scales can range from 0-5 to 0-25. Each of the question responses is summed for a total score ranging from 0 (worst symptom burden and function) to 100 (no symptom burden). There are two subscales within this tool: ankle function and ankle symptoms. However, the utility of the subscales is minimal secondary to the limited number of questions, thus they should not be utilized for research and have limited clinical applicability.
Key Strengths of OMAS in Ankle Fracture Assessment
The OMAS tool has been well-described within the orthopaedic literature as one of the most-studied ankle fracture outcome scores. It has also been translated into several different languages. This tool has minimal ceiling and floor effects and has demonstrated adequate structural validity and reliability. Furthermore, the score has been validated against several parameters associated with ankle fracture recovery, including a linear analog scale of subjective recovery, presence of osteoarthritis, range of motion, and presence of dislocation on radiographs. Its quick 9-question structure makes this tool easy for patients to complete in a timely manner and decreases burden on clinic staff.
Limitations and Considerations of Using OMAS
The brevity of this tool leads to a few limitations. Namely, the OMAS survey primarily measures function (6/9 questions) with only 3 questions covering other symptomatology. Additionally, this tool does not comprehensively cover all aspects of recovery that are important to patients within 9-questions. When compared to other PROMs for analysis of ankle fracture recovery such as the ankle-fracture outcome of rehabilitation measure (A-FORM), the OMAS lacks sufficient research regarding its content validity and internal consistency. Additionally, OMAS is among the lowest-ranking ankle fracture outcomes (second only to FAAM) when analyzed for clinical relevance.
OMAS Costs and Licensing Information
This tool is free to use and does not require any licensure.
Final Thoughts: Is OMAS Right for Your Clinical Practice?
As one of the most commonly utilized PROs for ankle fracture recovery, the OMAS is a quick tool to monitor patients in the vital post-injury recovery period. However, other surveys should be considered if looking for a well-validated PROM for research purposes.
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