Weight-Bearing Versus Non-Weight-Bearing After Ankle Fracture: A Systematic Review and Meta-Analysis of Patient-Reported Outcome

BACKGROUND: Ankle fractures commonly affect mobility and quality of life. Although unstable fractures typically require surgery, post-treatment protocols vary widely, including both surgical and conservative approaches. This systematic review and meta-analysis evaluated the effects of early weight-bearing after ankle fracture treatment on functional outcomes and quality of life. METHODS: Following the PRISMA guidelines and the PICOS strategy, we performed a meta-analysis across multiple databases (PubMed, Embase, Scopus, and Cochrane Library). Analysis was conducted using Review Manager 5.4, calculating the mean and standard mean differences with 95% confidence intervals (CIs). RESULTS: = 939) showed favorable outcomes with weight-bearing. Significant functional improvements were observed at 6 weeks (MD 7.88, 95% CI 3.14-12.61), 3 months (MD 5.79, 95% CI 4.41-7.17), and 12 months (MD 4.74, 95% CI 3.01-6.46). RAND scores favored the weight-bearing group at 6 weeks (SMD 0.48, 95% CI 0.26-0.70) and 12 months (SMD 0.31, 95% CI 0.07-0.55), with no significant differences at 3 months (SMD 0.18, 95% CI -0.10-0.46). CONCLUSION: The outcomes obtained indicated statistically significant differences in favor of the early weight-bearing group regarding ankle function and quality of life.