Does fixation of medium sized posterior malleolus fragment in ankle fractures yield superior outcomes than no-fixation? A systematic review and meta-analysis.
Baijaeek Sain, Aman Sethi, Suraj Suryawanshi et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the outcomes of surgical fixation versus non-fixation of medium-sized posterior malleolar fragments in tri-malleolar ankle fractures. Involving 883 patients across ten studies, the analysis found no significant differences in AOFAS scores, OMAS, or incidence of OA ≥grade 2 between the two management strategies, indicating that fixation may not yield superior outcomes.
Key findings
- No significant difference in AOFAS scores (MD 3.76, P = 0.31) between fixation and non-fixation groups.
- OMAS scores also showed no significant difference (MD 0.35, P = 0.92).
- The incidence of OA ≥grade 2 was similar in both groups (OR 0.84, P = 0.73).
Why it matters
Understanding the effectiveness of surgical fixation versus non-fixation for posterior malleolar fragments can guide treatment decisions in tri-malleolar ankle fractures, potentially reducing unnecessary surgical interventions.
What to keep in mind
High heterogeneity among studies limits the generalizability of the findings.