Zhao Ke, Dong Shilei, Wang Wei
College of Acupuncture-Moxibustion and Orthopedics, Hubei University of Traditional Chinese Medicine, Wuhan, China.
Department of Orthopedics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China.
Front Surg. 2022 Aug 16;9:911471. doi: 10.3389/fsurg.2022.911471. eCollection 2022.
The purpose of this study was to explore the safe and most effective initiation time for the functional recovery of patients with peri-ankle fractures after surgery.
We searched electronic databases, including the Cochrane Library, Embase, PubMed and the reference lists of relevant articles published from inception to October 30, 2021. Two researchers independently performed literature screening and data extraction and evaluated the quality of the included literature using the Newcastle-Ottawa Scale. Network meta-analysis, including consistency testing, publication bias, and graphical plotting, was performed using Stata (v16.0).
A total of 25 articles involving 1756 patients were included in this study. The results of the meta-analysis showed that functional exercise within 2 days after surgery may result in lower VAS scores compared to other techniques ( < 0.05). Functional exercise within 12 months may lead to higher AOFAS scores than that of other techniques ( < 0.05). The total postoperative complication rate, including deep vein thrombosis, showed no statistically significant differences between any two interventions ( > 0.05). The results of the surface under the cumulative ranking (SUCRA) showed that functional exercise within two days postoperatively may have the lowest VAS scores (SUCRA = 82.8%), functional exercise within 1 week postoperatively may have the lowest deep vein thrombosis rate (SUCRA = 66.8%), functional exercise within 10 days postoperatively may have the fewest total postoperative complication rate (SUCRA = 73.3%) and functional exercise within 12 months postoperatively may contribute to the highest AOFAS scores (SUCRA = 85.5%).
The results of this study suggest that initiation of rehabilitation within two days after surgery may be the best time to reduce postoperative pain; rehabilitation interventions within 10 days after surgery may be the optimal time for reducing the total postoperative complication rate, including deep vein thrombosis; and continued functional exercise within 12 months after surgery may steadily and ideally improve the function of the ankle joint.Systematic Review Registration: doi: 10.37766/inplasy2021.12.0030, identifier: INPLASY2021120030.
本研究旨在探讨踝关节周围骨折患者术后功能恢复的安全且最有效的起始时间。
我们检索了电子数据库，包括考克兰图书馆、Embase、PubMed以及从数据库建立至2021年10月30日发表的相关文章的参考文献列表。两名研究人员独立进行文献筛选和数据提取，并使用纽卡斯尔-渥太华量表评估纳入文献的质量。使用Stata（v16.0）进行网络荟萃分析，包括一致性检验、发表偏倚和图形绘制。
本研究共纳入25篇文章，涉及1756例患者。荟萃分析结果显示，与其他技术相比，术后2天内进行功能锻炼可能导致更低的视觉模拟评分（VAS）（<0.05）。术后12个月内进行功能锻炼可能比其他技术导致更高的美国足踝外科协会（AOFAS）评分（<0.05）。包括深静脉血栓形成在内的术后总并发症发生率在任何两种干预措施之间均无统计学显著差异（>0.05）。累积排序曲线下面积（SUCRA）结果显示，术后两天内进行功能锻炼可能具有最低的VAS评分（SUCRA = 82.8%），术后1周内进行功能锻炼可能具有最低的深静脉血栓形成率（SUCRA = 66.8%），术后10天内进行功能锻炼可能具有最少的术后总并发症发生率（SUCRA = 73.3%），术后12个月内进行功能锻炼可能有助于获得最高的AOFAS评分（SUCRA = 85.5%）。
本研究结果表明，术后两天内开始康复训练可能是减轻术后疼痛的最佳时机；术后10天内进行康复干预可能是降低包括深静脉血栓形成在内的术后总并发症发生率的最佳时机；术后12个月内持续进行功能锻炼可能稳定且理想地改善踝关节功能。系统评价注册：doi: 10.37766/inplasy2021.12.0030，标识符：INPLASY2021120030。
