SynthesisJournal of orthopaedic surgery and research2025
Early weight-bearing after ankle fracture surgery: a systematic review and meta-analysis of functional outcomes and safety.
Synthesis in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Clinical outcomes and feasibility of a fast-track protocol after total ankle replacement: a prospective study.Archives of orthopaedic and trauma surgery · 2026Observational
- Tibiotalocalcaneal arthrodesis versus open reduction and internal fixation in treatment of trimalleolar ankle fractures: A propensity-matched TriNetX database study.Journal of clinical orthopaedics and trauma · 2026Article
- [Full weight-bearing after geriatric ankle fractures-No problem?]Unfallchirurgie (Heidelberg, Germany) · 2026Review
- Risk stratification in diabetic ankle fractures: a systematic review of reviews and proposal of the MADRAS scoring system.Cardiovascular diabetology. Endocrinology reports · 2026Review
- [Minimally invasive surgery for insertional Achilles tendinopathy : Do Haglund resection, refixation of the Achilles tendon and Zadek osteotomy also work using minimally invasive techniques?]Orthopadie (Heidelberg, Germany) · 2026Review
- Postoperative mobility is associated with risk of reoperation and increased mortality after hip fracture: a nationwide cohort study of 33,486 patients.Acta orthopaedica · 2026Article
- Review
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2 authors.
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Abstract
backgroundEarly weight-bearing (EWB) following ankle fracture surgery represents a paradigm shift from traditional rehabilitation protocols. This systematic review and meta-analysis evaluated the efficacy and safety of early versus delayed weight-bearing following operative treatment of ankle fractures.
methodsWe systematically searched six databases (PubMed, EMBASE, Cochrane CENTRAL, Web of Science, CINAHL, PEDro) from January 2015 to February 2025. Twelve studies (1,847 participants) comparing early (≤ 2 weeks) versus delayed weight-bearing protocols were included. Primary outcomes included functional scores, pain, range of motion, and complications. Random-effects meta-analyses used standardized mean differences for continuous outcomes and risk ratios for dichotomous outcomes.
resultsEarly weight-bearing demonstrated significant advantages in pain reduction (SMD: +0.32, 95% CI: 0.21-0.43) and ankle dorsiflexion (SMD: +0.38, 95% CI: 0.26-0.50). Patients with EWB returned to work 12.3 weeks earlier and achieved clinically significant pain reduction 6 weeks sooner than delayed weight-bearing patients. Complication risk favored EWB (RR: 0.89, 95% CI: 0.69-1.14), with fewer immobilization-related complications (DVT: 2.5% vs. 6.3%; CRPS: 1.8% vs. 4.7%). Weber B fractures, younger age (< 45 years), and absence of syndesmotic injury predicted optimal EWB outcomes. Diabetic patients showed enhanced benefits from early mobilization compared to delayed protocols.
conclusionsEarly weight-bearing following ankle fracture surgery results in superior functional outcomes and equivalent safety compared to delayed protocols. Implementation within two weeks post-surgery appears optimal, with benefits most pronounced in Weber B fractures and younger patients. Syndesmotic injuries and diabetes require individualized assessment for optimal rehabilitation timing.
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