Abstract：
Postoperative care of ankle fractures treated with open reduction and internal fixation (ORIF) is a debated topic. A meta-analysis of Randomized Controlled Trials was conducted with the aim of comparing early mobilization and weightbearing to traditional postoperative protocols. A systematic search of electronic databases was conducted according to the PRISMA guidelines. Only randomized clinical trials were included. Data about clinical outcome, time to return to work and complications were extracted and summarized. Meta-analyses were performed. Twenty studies for a total of 1328 patients were included. Early mobilization was compared to immobilization in 724 patients: the two groups did not significantly differ in terms of short- and long-term clinical outcome (p = 0.08 and p = 0.41, respectively). However, early mobilization resulted to be significantly associated with faster return to work (p = 0.047). Early weightbearing was compared to nonweightbearing in 1088 patients. While the clinical difference between the two groups was not significant at short term (p = 0.08), it was significant at long term (p = 0.002). No other significant differences, in particular regarding complications, were highlighted between different groups. Early motion, early weightbearing and traditional postoperative protocols are all safe strategies after ORIF for unstable ankle fractures. Early mobilization is significantly associated with faster return to work and early weightbearing improves long term clinical outcome.Level of evidence: I.
摘要：
采用切开复位内固定（ORIF）治疗踝关节骨折的术后护理是一个有争议的话题。进行了随机对照试验的荟萃分析，目的是将早期动员和负重与传统的术后方案进行比较。根据PRISMA指南对电子数据库进行了系统搜索。仅包括随机临床试验。有关临床结果的数据，提取并总结了恢复工作的时间和并发症。进行Meta分析。共纳入20项研究，共1328名患者。在724例患者中，将早期动员与固定进行了比较：两组在短期和长期临床结果方面没有显着差异（分别为p=0.08和p=0.41）。然而,早期动员与更快恢复工作显著相关(p=0.047).在1088例患者中，早期负重与非负重进行了比较。虽然两组之间的临床差异在短期内并不显著（p=0.08），长期显著(p=0.002).无其他显著差异,特别是关于并发症，在不同的群体之间突出显示。早期动议，早期负重和传统的术后方案都是ORIF治疗不稳定踝关节骨折后的安全性策略.早期动员与更快的恢复工作显着相关，早期负重可改善长期临床结果。证据级别：I.
