New research shows that three weeks in a cast or ankle support may be just as good as six weeks for healing ankle fractures.
In a study published in The BMJ, the healing process after three weeks was just as successful compared with conventional therapy of six weeks, without any additional harm.
Prolonged immobilisation in a cast is associated with risks such as stiffness, skin damage and blocked blood vessels — not to mention the impact on patients’ everyday life.
Researchers in Finland conducted a randomised controlled trial involving 247 people aged 16 and above, with an average age of 45. All had sustained stable ankle fractures (fractures that don’t require surgery), which were confirmed by an external-rotation stress test.
The participants were randomly allocated to a treatment group: 84 people had the conventional six-week cast, 83 people spent three weeks in a cast, and 80 people wore a simple ankle brace for three weeks.
Follow-up appointments at six, 12 and 52 weeks measured ankle fracture symptoms using the Olerud-Molander Ankle Score (OMAS) and also assessed ankle function, pain, quality of life, ankle motion and X-ray results. Patients were also asked to describe any negative effects of the treatment.
The mean OMAS scores at one year showed that the three-week groups fared no worse than the six week group, with the three-week cast and ankle brace groups scoring 91.7 and 89.8, respectively, compared with 87.6 in the six-week group.
There was also a slight improvement in participants’ ankle mobility in the three-week ankle brace group, compared with the six-week group.
No significant differences were found between the groups with regard to harms.
Shorter and more convenient treatment strategies for stable ankle fractures can result in successful fracture healing, the researchers concluded.