The study was performed adhering to the PRISMA guidelines (preferred reporting items in systematic reviews and meta-analysis). Predictive factors such as fracture pattern, age and gender that may have an effect on the return to sporting activity will also be assessed. The outcome measures of interest are the rate of return to sport, the time taken to return to sport and the level of sporting activity achieved post-treatment. The present systematic review focuses exclusively on acute traumatic sport-related ankle fractures, and reviews the outcomes of both operative and non-operative management. The present updated systematic review provides a contemporary assessment of the literature on the return to sports following acute ankle fractures. 10 That review only included operatively-managed ankle fractures, and assessed the outcome of both acute and stress fractures. Only one previous systematic review, published in 2013, assessed return to sport after ankle fractures. 7 However, non-operative management can be used successfully for ‘stable’, undisplaced ankle fractures in athletic patients. 5 Open reduction and internal fixation, as a treatment option for the management of ankle fractures, 6 especially for athletes, may allow earlier mobilization and hence a quicker return to sports. 4 Return to sport is an important goal in treatment of ankle fractures in a sporting population. 1–3 Acute traumatic ankle fractures account for between 7% and9% of all acute sport-related fractures. Ankle injuries can occur in both competitive and recreational athletes, with a reported prevalence of 15–25% of all sports injuries.
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