The Impacts of COVID-19 on the Management of Ankle Fractures and their Outcomes: A Systematic Review

The COVID-19 pandemic is still an unresolved situation in Thailand and worldwide at large. The purpose of this study was to interpret the impacts of COVID-19 on the management of ankle fractures and their outcomes. A systematic search and review were performed in accordance with the PRISMA guideline based on the PubMed database. The search terms were ‘ankle fracture’ and ‘COVID’. From an initial search, a total of 29 abstracts were found and screened in accordance with the eligibility criteria. Then, five articles were considered eligible papers for further review. This review investigated a total of 16,813 patients with ankle fractures, including 215 patients (1.27%) who were also COVID-19-positive. According to our results, the incidence of ankle fractures showed a decrease during the pandemic. However, COVID-positive ankle fracture patients demonstrated a higher prevalence of comorbidities, including chronic kidney disease, diabetes, hypertension, and obesity. COVID-19 infection was a factor that delayed the operation and increased the length of hospital stay and adverse effects from the surgery. COVID-19 infection affected the management of ankle fractures and their outcomes in terms of negative impacts such as delayed operation, increased length of hospital stay, and increased adverse effects from the surgery. Outpatient surgery was recommended to solve some of these problems.