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Immediate weight bearing without immobilization for operatively treated ankle fractures is safe - A systematic review
S F Baumbach1, K Rellensmann1, F T Spindler1
1Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Ziemssenstraße 5, Munich 80336, Germany.
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:
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:
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:
Early and immediate WB and MB do not increase the complication rates but result in superior short term outcome scores.
Level Of Evidence:
Level I Systematic Review.
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