Jelle Spierings (Nieuwegein / NL), Thomas Nijdam (Nieuwegein / NL), Lizz van der Heijden (Leiden / NL), Henk Jan Schuijt (Nieuwegein / NL), Marike Kokke (Nieuwegein / NL), Detlef van der Velde (Nieuwegein / NL), Diederik Smeeing (Nieuwegein / NL)
Abstract text (incl. references and figure legends)
Purpose: There is currently no consensus on nonoperative management in adult patients after a stable type B ankle fracture. The aim of this review is to compare a removable orthosis versus a cast regarding safety and functional outcome in the NOM of stable type B ankle fractures.
Results: Five studies were included. Two were randomized clinical trials, and three were observational studies, including a total of 516 patients. A meta-analysis showed statistically significant higher odds of developing complications in the cast group (odds ratio (OR), 4.67 (95% Confidence Interval (CI) 1.52 to 14.35)) (figure 1). The mean difference of functional outcome in OMAS did not vary significantly at six weeks; OR -6.64 (95% CI -13.72 to 0.45)), and 12 weeks; OR -6.91 (95% CI -18.73 to 4.91) (figure 2). The mean difference of functional outcome in OMAS at 26 weeks or longer was significantly higher in the removable orthosis group in favour of the removable orthosis; OR -2.63 (95% CI -5.01 to -0.25).
Conclusion: Results of this systematic review and meta-analysis show that a removable orthosis is a safe alternative type of NOM, as complication numbers are significantly lower in the orthosis group. In addition, no statistically significant differences were found in terms of functional outcome between a removable orthosis and a cast at six and twelve weeks. After 26 weeks a removable orthosis is non-inferior to a cast in terms of functional outcome in patients with stable type B ankle fractures.
Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)
No