Gipsruhigstellung versus Vakuumstützsystem

Stöckle, Ulrich; König, B.; Tempka, A.; Südkamp, Norbert P.

doi:10.1007/s001130050525

Cited by 18 publications

(14 citation statements)

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“…• 8 studies (412 participants) 7,16,20,22,35,36,39,41 were pooled for outcome at 9 to 12 wk postoperation • Statistically significant difference in favor of early ankle movement, but this was a small mean difference of 1.9° of dorsiflexion (95% confidence interval: 0.5°, 3.3°; P = .008; I 2 = 46%)…”

Section: Summary Of Findingsmentioning

confidence: 99%

“…• 7 studies (369 participants) were pooled for outcome at 9 to 12 wk postoperation • An estimate was not calculated due to the very high levels of statistical heterogeneity (I 2 = 87%) • 3 studies 22,36,41 found statistically significant differences in favor of early ankle movement compared to immobilization • 4 studies 7,16,20,39 found no difference between treatment groups…”

Section: Summary Of Findingsmentioning

confidence: 99%

“…Postoperative swelling • 5 studies reported postoperative swelling • 3 studies were pooled (192 participants) 36,39,41 • No statistically significant difference between treatment groups in ankle circumference (difference between injured and uninjured in cm) at 6 to 10 wk postoperation (mean difference, -0.04 cm; 95% confidence interval: -0.32, 0.25 cm; P = .83; I 2 = 0%)…”

Section: Summary Of Findingsmentioning

confidence: 99%

“…All included studies were conducted in developed countries and reported in English, with the exception of 2 trials that were published in German. 22,36 Two studies were publicly funded, 12,20 1 was funded by the military, 6 and the remaining trials did not report a source of funding. Randomization occurred postoperatively in 11 studies reporting timing of randomization.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Venous Thromboembolism Four studies (245 participants) reported postoperative thromboembolism. 9,20,36,41 Of the 5 events reported, 4 were deep vein thrombosis and 1 was pulmonary embolism. All thromboembolic events occurred in the ankle immobilization group (5/119, 4.2%).…”

Section: Postoperative Complicationsmentioning

confidence: 99%

See 4 more Smart Citations

Early Ankle Movement Versus Immobilization in the Postoperative Management of Ankle Fracture in Adults: A Systematic Review and Meta-analysis

Keene¹,

Williamson²,

Bruce³

et al. 2014

J Orthop Sports Phys Ther

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T he incidence of ankle fracture is 71 per 100 000 person-years. There are age and sex differences, with peak incidence in younger men (between 15 and 29 years of age), whereas in women the incidence peaks at over 50 years of age. 38 Ankle fracture is caused by injury during physical activity and sport, and, in older people, osteoporosis is an important contributor. 19 Projections from Scandinavia suggest that the number of ankle fractures will increase 3-fold between 2006 and 2030, driven by the aging population 18 and increased participation of older people in sporting activities.1 Displaced and/or unstable ankle fractures often require surgery to restore and maintain congruence of ankle mortise. 15 The recommended surgical technique in developed countries over the last few decades has been open reduction and internal fixation. T T OBJECTIVES:To compare early ankle movement versus ankle immobilization after surgery for ankle fracture on clinical and patient-reported outcomes. T T BACKGROUND:A significant proportion of patients undergoing surgery for ankle fracture experience postoperative complications and delayed return to function. The risks and benefits of movement of the ankle in the first 6 weeks after surgery are not known, and clinical practice varies widely. T T METHODS:We searched bibliographic databases and reference lists to identify eligible trials. Two independent reviewers conducted data extraction and risk-of-bias assessments. T T RESULTS: Fourteen trials (705 participants)were included in the review, 11 of which were included in the meta-analysis. The quality of the trials was universally poor. The pooled effect of early ankle movement on function at 9 to 12 weeks after surgery compared to immobilization was inconclusive (standardized mean difference, 0.46; 95% confidence interval: -0.02, 0.93; P = .06; I 2 = 72%), and no differences were observed between groups at 1 year. The odds of venous thromboembolism were significantly lower with early ankle movement compared to immobilization (Peto odds ratio = 0.12; 95% confidence interval: 0.02, 0.71; P = .02; I 2 = 0%). Deep surgical site infection (Peto odds ratio = 7.08; 95% confidence interval: 1.39, 35.99; P = .02; I 2 = 0%), superficial surgical site infection, fixation failure, and reoperation to remove metalwork were more common after early ankle movement compared to immobilization. T T CONCLUSION:The quality of evidence is poor. The effects of early movement after ankle surgery on short-term functional outcomes are unclear, but there is no observable difference in the longer term. There is a small reduction in risk of postoperative thromboembolism with early ankle movement. Current evidence suggests that deep and superficial surgical site infections, fixation failure, and the need to remove metalwork are more common after early ankle movement. T T LEVEL OF EVIDENCE:Therapy, level 1a-. Ther 2014;44(9):690-701. Epub 6 August 2014. doi:10.2519/jospt.2014 Complete immobilization of the ankle by restraining ankle movement in a neutral position c...

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