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Compression therapy after ankle fracture surgery: a systematic review

Abstract

Purpose

The main purpose of this systematic review was to investigate the effect of compression treatment on the perioperative course of ankle fractures and describe its effect on edema, pain, ankle joint mobility, wound healing complication, length of stay (LOS) and time to surgery (TTS). The aim was to suggest a recommendation to clinicians considering implementing compression therapy in the standard care of the ankle fracture patient, based on the existing literature.

Methods

We conducted a systematic search of literature including studies concerning adult patients with unstable ankle fractures undergoing surgery, testing either intermittent pneumatic compression, compression bandage and/or compression stocking and reporting its effect on edema, pain, ankle joint mobility, wound healing complication, LOS and TTS. To conclude on data a narrative synthesis was performed.

Results

The review included eight studies (451 patients). Seven studies found a significant effect on edema, two studies described a significant reduction in pain, one a positive effect on ankle movement, two a positive effect on wound healing, one a reduction in LOS and finally two studies reported reduction in TTS. A systematic bias assessment showed that the included studies had methodological limitations influencing the confidence in the effect estimate.

Conclusions

Compression therapy has a beneficial effect on edema reduction and probably a positive effect on pain and ankle joint mobility, but with the methodological limitations in the included studies it is not possible to make a solid conclusion on the effect on wound healing, LOS and TTS.

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Correspondence to R. Winge.

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Conflict of interest

R. Winge, L. Bayer, H. Gottlieb and C. Ryge declare that they have no conflict of interest.

This current research did not involve human participants and/or animals, since it is based on data from different literature databases. This is also the reason for which no “informed consent” was needed.

Funding

The study was funded by the Research Unit and the Department of Orthopedic Surgery, Nordsjællands Hospital.

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Winge, R., Bayer, L., Gottlieb, H. et al. Compression therapy after ankle fracture surgery: a systematic review. Eur J Trauma Emerg Surg 43, 451–459 (2017). https://doi.org/10.1007/s00068-017-0801-y

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Keywords

  • Ankle fracture
  • Compression treatment
  • Edema
  • Pain
  • Wound complications
  • Length of hospitalization