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Journal article

Use of cast immobilization versus removable brace in adults with an ankle fracture: two-year follow-up of a multicentre randomized controlled trial

Abstract:

Aims: The aim of this study was to compare the longer-term outcomes of operatively and nonoperatively managed patients treated with a removable brace (fixed-angle removable orthosis) or a plaster cast immobilization for an acute ankle fracture.

Methods: This is a secondary analysis of a multicentre randomized controlled trial comparing adults with an acute ankle fracture, initially managed either by operative or nonoperative care. Patients were randomly allocated to receive either a cast immobilization or a fixed-angle removable orthosis (removable brace). Data were collected on baseline characteristics, ankle function, quality of life, and complications. The Olerud-Molander Ankle Score (OMAS) was the primary outcome which was used to measure the participant’s ankle function. The primary endpoint was at 16 weeks, with longer-term follow-up at 24 weeks and two years.

Results: Overall, 436 patients (65%) completed the final two-year follow-up. The mean difference in OMAS at two years was -0.3 points favouring the plaster cast (95% confidence interval -3.9 to 3.4), indicating no statistically significant difference between the interventions. There was no evidence of differences in patient quality of life (measured using the EuroQol five-dimension five-level questionnaire) or Disability Rating Index.

Conclusion: This study demonstrated that patients treated with a removable brace had similar outcomes to those treated with a plaster cast in the first two years after injury. A removable brace is an effective alternative to traditional immobilization in a plaster cast for patients with an ankle fracture.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1302/0301-620X.105B4.BJJ-2022-0602.R3

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
NDORMS
Sub department:
Botnar Research Centre
Oxford college:
Wolfson College
Role:
Author
ORCID:
0000-0003-3644-1388


Publisher:
British Editorial Society of Bone and Joint Surgery
Journal:
Bone and Joint Journal More from this journal
Volume:
105-B
Issue:
4
Pages:
382-388
Publication date:
2023-03-15
Acceptance date:
2023-01-18
DOI:
EISSN:
2049-4408
ISSN:
2049-4394


Language:
English
Keywords:
Pubs id:
1324948
Local pid:
pubs:1324948
Deposit date:
2023-01-23
ARK identifier:

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