Wound complications after cast immobilization compared to early functional treatment in surgical fixation of ankle fractures: A systematic review and meta-analysis of randomized controlled trials.

Study Summary

Ten randomized controlled trials including 1142 skeletally mature patients with surgically treated ankle fractures were included in this systematic review and meta-analysis comparing postoperative cast immobilization vs early functional treatment. The primary outcome of interest was a composite overall incidence of any wound complication. The secondary outcomes of interest were the incidence of impaired wound healing (wound dehiscence, wound necrosis), superficial infection, deep infection, and wound-related reoperations. Pooled outcomes included overall wound complications, impaired wound healing, superficial infection, deep infection, and wound-related reoperations. Early functional treatment was associated with significantly higher risks of overall wound complications, impaired wound healing, and superficial infection, whereas no significant differences were observed for deep infection or wound-related reoperations. Overall, postoperative cast immobilization reduced wound complications after ankle fracture fixation and may represent the safer postoperative strategy for wound healing.