dc.contributor.author | Javed, OA | |
dc.contributor.author | Javed, QA | |
dc.contributor.author | Ukoumunne, OC | |
dc.contributor.author | Di Mascio, L | |
dc.date.accessioned | 2020-12-14T05:38:20Z | |
dc.date.available | 2020-12-14T05:38:20Z | |
dc.date.issued | 2020-10-01 | |
dc.identifier | pii: S1268-7731(19)30171-7 | |
dc.identifier.citation | Javed, O. A., Javed, Q. A., Ukoumunne, O. C. & Di Mascio, L. (2020). Surgical versus conservative management of ankle fractures in adults: A systematic review and meta-analysis. FOOT AND ANKLE SURGERY, 26 (7), pp.723-735. https://doi.org/10.1016/j.fas.2019.09.008. | |
dc.identifier.issn | 1268-7731 | |
dc.identifier.uri | http://hdl.handle.net/11343/253964 | |
dc.description.abstract | AIMS: This study compared outcomes of surgical versus conservative management of ankle fractures in adults through a systematic review and meta-analysis. METHODS: We searched CINAHL, EMBASE, MEDLINE and CENTRAL databases (1946-June 2019) for randomised and quasi-randomised controlled trials comparing surgical versus conservative management of closed adult ankle fractures of any type. Estimates of effect were pooled using random effects meta-analysis. RESULTS: 1153 patients from 7 trials were included. Our primary outcome, ankle function score, was not statistically significantly different at 6-months (pooled mean difference (surgical minus conservative) = 1.0; 95% CI: -2.3 to 4.3; p = 0.55) or 12-months or more (pooled mean difference = 4.6; 95% CI: -1.0 to 10.2; p = 0.11) between surgical and conservative groups in three trials assessing displaced or unstable fractures, and two trials using non-validated questionnaires. One trial assessing AO-type-B1 fractures without talar shift had a statistically significant difference favouring conservative management, which was not clinically meaningful. Surgery had lower rates of early treatment failure and malunion/non-union, but higher rates of further surgery and infection. CONCLUSIONS: Surgical and conservative management of displaced or unstable ankle fractures produce similar short-term functional outcomes. The higher risk of early treatment failure and malunion/non-union in the conservative group versus higher rates of further surgery and infection in the surgical group should be considered. Trials are needed to assess longer-term results and inform management of select patient groups. | |
dc.language | English | |
dc.publisher | ELSEVIER | |
dc.title | Surgical versus conservative management of ankle fractures in adults: A systematic review and meta-analysis | |
dc.type | Journal Article | |
dc.identifier.doi | 10.1016/j.fas.2019.09.008 | |
melbourne.affiliation.department | Paediatrics (RCH) | |
melbourne.source.title | Foot and Ankle Surgery | |
melbourne.source.volume | 26 | |
melbourne.source.issue | 7 | |
melbourne.source.pages | 723-735 | |
melbourne.elementsid | 1426883 | |
melbourne.openaccess.url | https://ore.exeter.ac.uk/repository/bitstream/10871/40219/4/Manuscript.pdf | |
melbourne.openaccess.status | Accepted version | |
melbourne.contributor.author | Ukoumunne, Obioha | |
dc.identifier.eissn | 1460-9584 | |
melbourne.accessrights | Access this item via the Open Access location | |