Evidence map›Paper›PMID 40285875›Full record

SynthesisArchives of orthopaedic and trauma surgery2025

The impact of surgical timing in ankle fracture on postoperative wound complications: a critical 24-hour cutoff point through systematic review and meta-analysis.

Alexander Edelstein, John McDonald, Wonyong Lee

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. [Preoperative application effect of reverse traction technique in trimalleolar fracture-dislocation of ankle].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Alexander EdelsteinGuthrie Robert Packer Hospital, Sayre, USA.
John McDonaldGeisinger Commonwealth School of Medicine, Scranton, PA, USA.
Wonyong LeeUniversity of Chicago, Chicago, USA. wonyonglee.md@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnkle fractures are among the most prevalent injuries in the general population, and the timing of surgical fixation may influence postoperative wound complications. This systematic review and meta-analysis investigated the impact of surgical timing on postoperative wound complications, specifically investigating the significance of a 24-hour cutoff point. MATERIALS AND

methodsThe comprehensive literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using PubMed, Embase, Web of Science, and Cochrane databases. Research evaluating and comparing clinical outcomes following ankle fracture treatment between early versus delayed surgical fixation groups, specifically using a 24-hour cutoff point, were reviewed. Evaluated data for the meta-analysis included total wound complications: divided into major and minor wound complications, length of stay, and other complications such as fixation failure.

resultsA total of eight studies were included in this systematic review and meta-analysis. In total, 1,183 patients were analyzed, with 572 in the early fixation group and 611 in the delayed fixation group. Compared to the delayed fixation group, the early fixation group significantly reduced total wound complications and length of stay, with a relative ratio of 0.37 (95% CI, 0.22 to 0.60) and - 0.88 (95% CI, -1.07 to -0.70), respectively. When analyzed as separate groups of major and minor wound complications, there was a trend showing lower rate of major and minor wound complication in the early fixation group than the delayed fixation group, but without reaching statistically significant differences.

conclusionsBased on our review, early surgical intervention within the first 24 h may be considered to minimize the risk of postoperative wound complications and reduce the length of stay in ankle fractures. LEVEL OF EVIDENCE: Level 3.

Indexed as

Ankle FracturesFracture Fixation, InternalPostoperative ComplicationsSurgical Wound InfectionTime-to-TreatmentHumansLength of StayTime Factors24 HoursAnd length of stayAnkle fractureDelayed fixationEarly fixationPostoperative wound complicationsSurgical timing

Identifiers

PMID40285875

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.