Preparations inadequate for potential ankle injuries
The results of a significant study comparing the use of a cast and a removable brace for treating broken ankles have been published today in The BMJ. The research, known as the Ankle Injury Rehabilitation (AIR) Trial, was conducted by the University of Warwick and led by Professor Michael R. Whitehouse.
The study, titled 'Use of cast immobilisation versus removable brace in adults with ankle fracture: multicentre randomised controlled trial', involved 669 participants who were randomly given either a cast or a removable brace to immobilize their foot following an ankle fracture. The trial was funded by the National Institute for Health Research (NIHR).
The removable brace, often referred to as the 'Beckham boot', is a plastic boot that comes in two halves with Velcro to wrap round and secure it. It is designed to be walked on and being removable allows patients to perform leg exercises and keep their leg clean. Some evidence suggests that the flexibility of the removable brace could prove more appealing to patients.
However, according to Professor Kearney, who was supported by an NIHR Fellowship for this research, the use of a removable brace did not result in better functional outcomes in the trial. Professor Kearney notes that when patients swapped treatments, they swapped in predominantly one direction - from the cast to the brace.
The trial followed up with the patients after four months using a questionnaire that asked about pain, functionality, and other related issues. The results showed no statistically significant difference in the scores of those using a cast and those using a removable brace.
Not all ankle fractures require surgery, but patients will need to keep their foot immobilized for around 6 weeks to allow the bones to heal. The choice between a cast and a removable brace, according to the findings, should be down to cost and patient preference.
The DOI for the research paper is 10.1136/bmj.n1506, and it will be live after the embargo lifts. The journal for the research paper is The BMJ.
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