Do exercises improve outcome following fixation of ankle fractures? A systematic review

Abstract

The aim of this review was to evaluate the literature that assessed whether postoperative ankle mobilization exercises improve outcome following open reduction and internal fixation of ankle fractures. An electronic search was undertaken of the databases AMED, Cinahl, Embase, Medline (via Ovid), PEDro and PubMed, from their inception to December 2005. Controlled clinical trials comparing the effects of postoperative ankle exercises with subjects who were not prescribed exercises following open reduction and internal fixation of ankle fractures were included. Two reviewers independently assessed the methodological quality of the literature using the PEDro (Physiotherapy Evidence Database) scoring system. In total, 15 articles of 870 ankle fractures were reviewed. Overall, postoperative ankle exercises neither improved nor jeopardized short- or longer-term outcomes following open reduction and internal fixation of ankle fractures. However, owing to the plethora of methodological limitations and limited evidence, it is not possible to firmly establish this conclusion. Further large, well-designed randomized controlled trials are required to evaluate this topic.