Casting for Ankle Fractures? 3 Weeks May Be Enough

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

For patients with stable fibula fractures, wearing a cast or orthosis for 3 weeks may be just as effective as wearing a cast for 6 weeks, according to a noninferiority trial in The BMJ.

Nearly 250 Finnish patients aged 16 and older with new, stable fibula fractures were randomized to receive a below-the-knee cast for 6 weeks (considered standard treatment) or to receive a cast or orthotic device for 3 weeks. All patients were allowed to bear weight on the fractured ankle right after receiving the cast or orthosis. Those who received orthoses could take off the device as needed and move their ankle at will.

At 1 year, the primary outcome — an ankle fracture symptom score — was similar between the 6-week casting group and each of the 3-week groups. Overall, 99% of patients achieved fracture union, and the rate did not differ significantly across the groups.