Bracing Is Better Than Casting for Some Ankle Fractures

Studies have shown that casting might not be necessary for some common childhood fractures, such as wrist buckle fractures (JW Pediatric and Adolescent Medicine May 26 2006). In a randomized study, investigators in Canada compared a below-knee fiberglass walking cast and a removable air-stirrup ankle brace in 111 children (age range, 5–18 years) who presented to an emergency department with isolated low-risk fractures of the distal fibula (Salter-Harris types I and II and avulsion fractures of the fibular epiphysis and distal fibula).

The walking cast was removed after 3 weeks, and patients removed the brace when ambulation became comfortable, but not before day 5. Four weeks after injury, a researcher blinded to type of immobilization evalu…