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Use of cast immobilisation versus removable brace in adults with an ankle fracture: multicentre randomised controlled trial
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Use of cast immobilisation versus removable brace in adults with an ankle fracture: multicentre randomised controlled trial
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Use of cast immobilisation versus removable brace in adults with an ankle fracture: multicentre randomised controlled trial
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Journal Article
Use of cast immobilisation versus removable brace in adults with an ankle fracture: multicentre randomised controlled trial
2021
Overview
AbstractObjectivesTo assess function, quality of life, resource use, and complications in adults treated with plaster cast immobilisation versus a removable brace for ankle fracture.DesignMulticentre randomised controlled trial.Setting20 trauma units in the UK National Health Service.Participants669 adults aged 18 years and older with an acute ankle fracture suitable for cast immobilisation: 334 were randomised to a plaster cast and 335 to a removable brace.InterventionsA below the knee cast was applied and ankle range of movement exercises started on cast removal. The removable brace was fitted, and ankle range of movement exercises were started immediately.Main outcome measuresPrimary outcome was the Olerud Molander ankle score at 16 weeks, analysed by intention to treat. Secondary outcomes were Manchester-Oxford foot questionnaire, disability rating index, quality of life, and complications at 6, 10, and 16 weeks.ResultsThe mean age of participants was 46 years (SD 17 years) and 381 (57%) were women. 502 (75%) participants completed the study. No statistically significant difference was found in the Olerud Molander ankle score between the cast and removable brace groups at 16 weeks (favours brace: 1.8, 95% confidence interval −2.0 to 5.6). No clinically significant differences were found in the Olerud Molander ankle scores at other time points, in the secondary unadjusted, imputed, or per protocol analyses.ConclusionsTraditional plaster casting was not found to be superior to functional bracing in adults with an ankle fracture. No statistically difference was found in the Olerud Molander ankle score between the trial arms at 16 weeks.Trial registrationISRCTN registry ISRCTN15537280.
Publisher
BMJ Publishing Group LTD,BMJ Publishing Group Ltd
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