Surgical therapy vs conservative therapy for patients with acute injury of lateral ankle ligament: A meta‐analysis and systematic review
Surgical therapy vs conservative therapy for patients with acute injury of lateral ankle ligament: A meta‐analysis and systematic review
复制标题
踝关节外侧韧带急性损伤患者的手术治疗与保守治疗：荟萃分析和系统评价
DOI：
10.1111/iwj.13120
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发表时间：
2019
影响因子：
3.1
通讯作者：
Naicheng Diao
中科院分区：
文献类型：
--
作者：
Feng Liu;Naicheng Diao
The goal of this meta‐analysis was to explore the overall safety and efficacy of surgical therapy vs conservative therapy for acute injury of the lateral ankle ligament based on eligible studies. Eligible studies were identified by searching PubMed, Cochrane, and Embase databases using appropriate updated index words to January 2018. We also searched relevant publication sources. Eligible studies included randomised controlled trials and comparative studies. Mean difference or relative risk (RR), along with 95% confidence interval (CI), was used to analyse the main outcomes. A total of 13 studies were eligible for this meta‐analysis, with 834 patients in the surgical therapy group and 930 patients in the conservative therapy group. Compared with patients receiving conservative treatment, patients undergoing surgical treatment had a significant higher American Orthopedic Foot And Ankle Society (AOFAS) score (weighted mean difference(WMD): 10.33, 95% CI: 6.83‐13.83) and an effective rate (RR: 1.15, 95% CI: 1.04‐1.28). No significant differences were observed in the incidence of recurrent ankle injury (RR: 1.01, 95% CI: 0.62‐1.65), limited range of motion (RR: 1.44, 95% CI: 0.83‐2.50), deep vein thrombosis (RR: 1.33, 95% CI: 0.73‐2.41), and wound infection or necrosis (RR: 3.99, 95% CI: 0.45‐35.34). However, compared with patients receiving conservative treatment, patients undergoing surgical therapy had significantly increased rates of complications (RR: 3.31, 95% CI: 2.55‐4.28), ankylosis (RR: 3.63, 95% CI: 2.16‐6.08), scare tenderness (RR: 10.16, 95% CI: 3.89‐26.52) and sensory loss (RR: 5.66, 95% CI: 2.76‐11.59). The results demonstrated that surgical treatment increased the AOFAS score and effective rate compared with conservative treatment. Besides, surgical treatment increased the rate of complications. Nevertheless, more high‐quality randomised controlled trials with a larger sample size conducted at multiple centres with a long‐term follow up are needed to confirm our conclusions.
