This systematic review and meta-analysis looked at skeletally mature patients with ankle fractures. The researchers compared early functional treatment against cast immobilization lasting more than two weeks. They analyzed data from 1,142 patients to see how these different approaches affected wound healing and infection rates.
The study found a higher risk of wound complications in the group receiving early functional treatment. Specifically, 14% of patients in this group had complications compared to 6% in the cast group. The risk of impaired wound healing was also higher for those treated functionally early on. Superficial infections were more common in the early functional treatment group as well.
There was no significant difference in the risk of deep infections or the need for reoperations related to wounds between the two groups. The researchers did not report specific safety concerns or adverse events in their findings. Readers should understand that this analysis shows a link between treatment type and wound outcomes, but it does not prove one method causes the other. This evidence comes from a meta-analysis, which combines results from multiple studies to provide a broader view.