Study Design Systematic review and meta-analysis of longitudinal studies. Objectives To quantify the prognosis of physical function following ankle fracture. Background Information about the course of recovery of physical function after ankle fracture is essential for patient care and healthcare policy. The existing data have not previously been included in a meta-analysis. Methods Studies were identified using searches of electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PEDro, AMED, SPORTDiscus) and grey literature to September 2012. Studies of people with traumatic ankle fracture were included. Two reviewers independently screened references for inclusion then extracted data and evaluated risk of bias. The outcome of interest was physical function (physical activity and activity limitation). Outcomes were converted to a common 100-point scale on which higher scores indicate better outcomes. Meta-regression was conducted using generalized estimating equations. Results 31 studies (37 articles) were included. Adults with ankle fracture present with significant activity limitation in the short-term (mean at 1 month 31.9, 95% CI 18.8, 45.1), recovered markedly but incompletely in the short- to medium-term (mean at 6 months 78.3, 95% CI 70.1, 85.1), and showed little further improvement in the long-term (mean at 24 months 86.6, 95% CI 78.2, 95.0). Studies with older participants and predominantly male participants tended to report worse functional outcomes. Conclusions Adults typically experience a rapid initial recovery of physical function after ankle fracture (approximately 80% function at 6 months), but on average, recovery remains incomplete 24 months after injury. Level of Evidence Prognosis, level 1. J Orthop Sports Phys Ther, Epub 30 September 2014. doi:10.2519/jospt.2014.5199.
a1938-1344 (Electronic)