The goal of this randomized clinical trial was to compare the effect of 6-week casting versus 2-week casting followed by 4-week ankle bracing in adult patients with surgically treated ankle fractures. The primary outcome measures used were the functional results 3 months after surgery evaluated using two functional outcome measures (Olerud and Molander score and Kaikkonen score) and the patient return to work. In the casting group, the traditional plaster was changed to a fiberglass one at 2 weeks and the cast treatment continued until 6 weeks. In the functional treatment group, the traditional plaster cast was changed to an reusable semi-rigid plastic orthosis (Aircast) at 2 weeks after surgery and its use was continued as an ankle support for up to 6 weeks. Follow-ups including subjective and objective evaluations were at 2, 6, 12 and 52 weeks and at 2 years postoperatively.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
134
Participants in the bracing group had a cast for 2 weeks after the surgery followed by ankle brace for 4 weeks.
Participants in the casting group had a cast for 6 weeks after the surgery.
Olerud-Molander score
Patient-reported outcome measure, 0-100 points, higher points indicating better result.
Time frame: 3 months and 24 months
Olerud-Molander score
Patient-reported outcome measure, 0-100 points, higher points indicating better result.
Time frame: 6 weeks and 12 months
Kaikkonen score
Patient-reported outcome measure, 0-100 points, higher points indicating better result.
Time frame: 6 weeks, 3, 12, and 24 months
Visual Analog Scale for Pain
0-10, higher score indicating more pain.
Time frame: 6 weeks, 3, 12, and 24 months
Swelling of the ankle
Circumference in millimetres compared to unaffected side
Time frame: 6 weeks, 3, 12, and 24 months
Atrophy of the calf muscles
Circumference in millimetres compared to unaffected side
Time frame: 6 weeks, 3, 12, and 24 months
Ankle active dorsiflexion
Degrees compared to unaffected side
Time frame: 6 weeks, 3, 12, and 24 months
Ankle active plantarflexion
Degrees compared to unaffected side
Time frame: 6 weeks, 3, 12, and 24 months
Return-to-work
Days after the injury
Time frame: Within 24 months
Subjective symptoms and return to activities
The patients were questioned about the subjective symptoms (pain, swelling, stiffness and giving way) and about the compliance of using the cast or brace. In addition the patients were asked about the length of their inability to work and participate in the daily activities and/or sports at the preinjury level.
Time frame: 2 and 6 weeks; 3, 12, and 24 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.