George Institute for International Health, University of Sydney, NSW, Australia.
Eur J Phys Rehabil Med. 2009 Sep;45(3):431-41. Epub 2008 Dec 16.
Ankle fracture is one of the most common lower limb fractures. People experience limitations in activities after ankle fracture.
The aim of this review was to evaluate the effects of rehabilitation interventions after ankle fracture in adults.
Electronic databases, reference lists of included studies and relevant systematic reviews, and clinical trials registers were searched for randomised and quasi-randomised controlled trials with adults undergoing any interventions for rehabilitation after ankle fracture. The primary outcomes were activity limitation and adverse events. Two reviewers independently screened search results, assessed methodological quality, and extracted data.
Thirty-one studies were included. Clinical and statistical heterogeneity, or the low number of studies in the comparison, prevented meta-analyses in most instances. After surgical fixation, commencing exercise in a removable brace or splint significantly improved activity limitation but also led to a higher rate of adverse events (relative risk 2.61, 95% CI 1.72 to 3.97). Most other rehabilitation interventions did not show an effect in improving activity limitation.
There is limited evidence supporting the use of a removable type of immobilisation and exercise during the immobilisation period for improving activity limitation. Because of the potential increased risk, the patient's ability to comply with this treatment regimen is essential. More clinical trials that are well-designed and adequately-powered are required to strengthen current evidence.
踝关节骨折是最常见的下肢骨折之一。骨折后，人们的活动会受到限制。
本综述旨在评估成人踝关节骨折后康复干预的效果。
电子数据库、纳入研究的参考文献列表和相关系统评价以及临床试验登记处均检索了随机和半随机对照试验，这些试验纳入了接受任何康复干预措施的踝关节骨折成年人。主要结局指标是活动受限和不良事件。两位评审员独立筛选检索结果、评估方法学质量并提取数据。
共纳入 31 项研究。在大多数情况下，由于临床和统计学异质性，或比较中研究数量较少，无法进行荟萃分析。在接受手术固定后，使用可移动支具或夹板进行运动可显著改善活动受限，但也会导致更高的不良事件发生率（相对风险 2.61，95%CI 1.72 至 3.97）。其他大多数康复干预措施对改善活动受限均无效果。
有有限的证据支持在固定期使用可移除类型的固定和运动来改善活动受限。由于潜在的风险增加，患者对这种治疗方案的依从性至关重要。需要更多设计良好且充分有效的临床试验来加强现有证据。
