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Brace better than cast for some ankle fracture

A removable ankle brace is better and more effective than a cast for treating low-risk ankle fractures in children.

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A removable ankle brace is better and more effective than a cast for treating low-risk ankle fractures in children with a faster recovery, and is cost effective as well.The lower leg contains two bones called tibia and fibula. The fibula is thinner and runs along the outer part of the leg. A fracture of the fibula at the ankle is common in children and at very low risk for future complications. However, the treatment still consists of immobilisation with a cast for 3 to 4 weeks.To analyse the benefits of a removable ankle brace as compared to a cast, researchers from the Toronto's Hospital for Sick Children conducted a trial where they compared the two treatment modalities in children with fractures of the lower end of fibula. Subjects in the age group 5-18 years were randomly assigned to a below-knee fibreglass walking cast or the ankle brace. Patients were instructed to avoid weight bearing for 5 days, then to bear weight as tolerated. After the pain resolved, they were shifted to unassisted weight bearing and normal activities.It was found that very few children in the cast group had returned to usual activities by the fourth week, and children who had casts had to make more visits to the doctor than those assigned to the removable brace. At the end of 4 weeks, fewer patients were happy with the cast than those with a brace. Also, parents of children in the brace group were more satisfied with the treatment.The brace is a more efficient, convenient and cheaper treatment option requiring fewer follow-ups, as compared to a cast for treating low-risk ankle fractures in children.
Pediatrics,
June 2007

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