Immediate weight bearing without immobilization for operatively treated ankle fractures is safe - A systematic review.

Full-weightbearing Mobilization Postoperative treatment Surgically treated ankle fracture

Journal

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons
ISSN: 1460-9584
Titre abrégé: Foot Ankle Surg
Pays: France
ID NLM: 9609647

Informations de publication

Date de publication:
Jun 2023
Historique:
received: 08 08 2022
revised: 26 03 2023
accepted: 13 04 2023
medline: 29 5 2023
pubmed: 20 4 2023
entrez: 19 04 2023
Statut: ppublish

Résumé

This systematic literature review compared weight bearing (WB) vs. partial- / non-weight bearing (NWB) and mobilization (MB) vs. immobilization (IMB) for surgically treated ankle fractures. Five databases were searched. Eligible were (quasi-)randomized controlled trials comparing at least two different postoperative treatment protocols. The risk of bias was assessed using the RoB-2 toolkit. The primary outcome was complication rate, secondary outcome Olerud and Molander Ankle Score (OMAS), range of motion (ROM), and return to work (RTW). Out of 10,345 studies, 24 papers were eligible. Thirteen studies (n = 853) compared WB/NWB, 13 studies (n = 706) MB/IMB with a moderate study quality. WB did not increase the risk for complications but resulted in superior short-term outcomes for OMAS, ROM, RTW. 12 studies found no inferior results for MB compared to IMB. Early and immediate WB and MB do not increase the complication rates but result in superior short term outcome scores. Level I Systematic Review.

Sections du résumé

BACKGROUND BACKGROUND
This systematic literature review compared weight bearing (WB) vs. partial- / non-weight bearing (NWB) and mobilization (MB) vs. immobilization (IMB) for surgically treated ankle fractures.
METHODS METHODS
Five databases were searched. Eligible were (quasi-)randomized controlled trials comparing at least two different postoperative treatment protocols. The risk of bias was assessed using the RoB-2 toolkit. The primary outcome was complication rate, secondary outcome Olerud and Molander Ankle Score (OMAS), range of motion (ROM), and return to work (RTW).
RESULTS RESULTS
Out of 10,345 studies, 24 papers were eligible. Thirteen studies (n = 853) compared WB/NWB, 13 studies (n = 706) MB/IMB with a moderate study quality. WB did not increase the risk for complications but resulted in superior short-term outcomes for OMAS, ROM, RTW. 12 studies found no inferior results for MB compared to IMB.
CONCLUSION CONCLUSIONS
Early and immediate WB and MB do not increase the complication rates but result in superior short term outcome scores.
LEVEL OF EVIDENCE METHODS
Level I Systematic Review.

Identifiants

pubmed: 37076381
pii: S1268-7731(23)00075-9
doi: 10.1016/j.fas.2023.04.006
pii:
doi:

Types de publication

Systematic Review Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

306-316

Informations de copyright

Copyright © 2023 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest statement The author(s) received no financial or material support for the research, authorship, and/or publication of this article.

Auteurs

S F Baumbach (SF)

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Ziemssenstraße 5, Munich 80336, Germany.

K Rellensmann (K)

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Ziemssenstraße 5, Munich 80336, Germany.

F T Spindler (FT)

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Ziemssenstraße 5, Munich 80336, Germany.

W Böcker (W)

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Ziemssenstraße 5, Munich 80336, Germany.

A D Barg (AD)

Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

T Mittlmeier (T)

Department of Trauma, Hand and Reconstructive Surgery, Rostock University Medical Center, Schillingallee 35, Rostock 18057, Germany.

S Ochman (S)

Department of Trauma, Hand, and Reconstructive Surgery, University Hospital, Westfalian Wilhems University Muenster, Albert Schweitzer Campus 1, W1, Muenster 48149, Germany.

S Rammelt (S)

University Center for Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at TU Dresden, Fetscherstrasse 74, Dresden 01307, Germany.

H Polzer (H)

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Ziemssenstraße 5, Munich 80336, Germany. Electronic address: Hans.Polzer@med.uni-meunchen.de.

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Classifications MeSH