Monestier Luca, Riva Giacomo, Coda Zabetta Lorenzo, Surace Michele F
Division of Orthopedics and Traumatology, ASST Sette Laghi, Varese, Italy.
Residency program in Orthopedics and Trauma, Department of Biotechnologies and Life Sciences (DBSV), University of Insubria, Varese, Italy.
Orthop Rev (Pavia). 2022 May 31;14(4):35688. doi: 10.52965/001c.35688. eCollection 2022.
Unstable ankle fractures are very frequent. Given the instability, they often require surgical treatment, but literature scarcely reports on the outcomes of their management.
QUESTIONS/PURPOSES: For this systematic review we asked: (1) What are the outcomes in treatment of unstable ankle fractures? (2) What about complications of treatment in unstable fractures? (3) What factors influence the outcomes? (4) What about the role of the posterior malleolus?
The electronic databases PubMed, Scopus, and Embase were interrogated using the search terms "bimalleolar" or "trimalleolar" and "fracture". Studies were included if they reported on: (1) bimalleolar or trimalleolar fracture in adults; (2) treatment; (3) outcomes reported by scales; (4) follow-up. The final review included 33 studies. The quality of the studies was evaluated with the Methodological Index for Non-randomized Studies (MINORS) questionnaire.
All the outcomes of the thirty-three selected studies were analyzed.
Surgical fixation of unstable ankle fractures should always be performed within the first 48 hours from the trauma, preventing instability and post-traumatic osteoarthritis. Surgeon should consider factor may influence functional outcomes. Posterior malleolar fractures should be fixed regardless the size, considering some individual factors.
不稳定型踝关节骨折非常常见。鉴于其不稳定性，通常需要手术治疗，但文献中很少报道其治疗结果。
问题/目的：对于本系统评价，我们提出以下问题：（1）不稳定型踝关节骨折的治疗结果如何？（2）不稳定型骨折治疗的并发症情况如何？（3）哪些因素会影响治疗结果？（4）后踝的作用是什么？
使用搜索词“双踝”或“三踝”以及“骨折”检索电子数据库PubMed、Scopus和Embase。如果研究报告了以下内容，则纳入研究：（1）成人双踝或三踝骨折；（2）治疗方法；（3）量表报告的结果；（4）随访情况。最终纳入33项研究。采用非随机研究方法学指数（MINORS）问卷对研究质量进行评估。
对33项入选研究的所有结果进行了分析。
不稳定型踝关节骨折的手术固定应在创伤后48小时内进行，以防止不稳定和创伤后骨关节炎。外科医生应考虑可能影响功能结果的因素。无论后踝骨折大小如何，都应考虑一些个体因素进行固定。
