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Weight-Bearing and Mobilization in the Postoperative Care of Ankle Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies

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Listed:
  • Diederik P J Smeeing
  • Roderick M Houwert
  • Jan Paul Briet
  • Johannes C Kelder
  • Michiel J M Segers
  • Egbert Jan M M Verleisdonk
  • Luke P H Leenen
  • Falco Hietbrink

Abstract

Purpose: To determine the effectiveness and safety of interventions used for rehabilitation after open reduction and internal fixation of ankle fractures. Methods: A systematic review and meta-analysis was performed using both randomized trials and cohort studies. The effect of mobilization, weight-bearing, and unprotected weight-bearing as tolerated on postoperative recovery was compared using the Olerud Molander score, return to work/daily activities, and the rate of complications. Results: A total of 25 articles were included. Ankle exercises resulted in earlier return to work and/or daily activities compared to immobilization (mean difference (MD) -20.76 days; 95% confidence interval (CI) -40.02 to -1.50). There was no difference in the rate of complications between exercises and immobilization (risk ratio (RR) 1.22; 95% CI 0.60 to 2.45) or between early and late weight-bearing (RR 1.26; 95%CI 0.56 to 2.85). Interpretation: Results of this meta-analysis show that following ankle surgery, 1) active exercises accelerate return to work and daily activities compared to immobilization, 2) early weight-bearing tends to accelerate return to work and daily activities compared to late weight-bearing. Active exercises in combination with immediate weight-bearing may be a safe option.

Suggested Citation

  • Diederik P J Smeeing & Roderick M Houwert & Jan Paul Briet & Johannes C Kelder & Michiel J M Segers & Egbert Jan M M Verleisdonk & Luke P H Leenen & Falco Hietbrink, 2015. "Weight-Bearing and Mobilization in the Postoperative Care of Ankle Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-12, February.
    • Handle: RePEc:plo:pone00:0118320
    DOI: 10.1371/journal.pone.0118320
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    Cited by:

    1. Sang-June Lee & Youngrak Choi & Seongju Choi & Hoseong Lee, 2022. "Early Return to Daily Life through Immediate Weight-Bearing after Lateral Malleolar Fracture Surgery," IJERPH, MDPI, vol. 19(10), pages 1-8, May.

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