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Sports Injuries

Updated 08 February 2019

Ditch the cast – broken ankles may heal in half the time

Finnish researchers decided to find out if three weeks of treatment for an ankle fracture that didn't require surgery would be as effective as six.

Three weeks in a cast or brace may be just as effective in healing ankle fractures as the typical six weeks, a new study shows.

While six weeks in a cast is the usual treatment, there are risks associated with prolonged immobilisation, including stiffness, skin damage and blocked blood vessels.

Shorter treatment brings no harm

Finnish researchers decided to find out if three weeks of treatment would be as effective as six. Their study included 247 patients who were 16 and older with a common type of stable fracture that didn't require surgery.

Eighty-four patients wore a cast for six weeks; 83 spent three weeks in a cast; and 80 spent three weeks in an ankle brace. They were assessed at six, 12 and 52 weeks after their fracture.

The healing process for those who spent three weeks in a cast or brace was as successful as among those who spent six weeks in a cast, and shorter treatment brought no added harm, according to the study published in the journal BMJ.

'A strong case'

In addition, those who wore a brace for three weeks had slightly better ankle mobility than participants who wore a cast for six weeks.

The findings were similar after accounting for patient differences, according to the researchers led by Dr Tero Kortekangas, from Oulu University Hospital in Finland.

His team used an external-rotation (ER) stress test to confirm stable fractures. Though the test is not used in all hospitals, the authors said in a journal news release that their findings "make a strong case for wider adoption of ER stress testing".

Because stable ankle fractures don't require surgery, shorter and more convenient treatment could provide successful healing, they concluded.

Image credit: iStock

 

Ask the Expert

Sports Injuries Expert

Adrian Rotunno is a medical doctor in the Sports & Exercise Medicine fellowship at the Sports Science Institute of South Africa, and qualified physiotherapist. Team physician for Dimension Data pro-cycling, and Boland Rugby. Special interests include endurance sport, in particular cycling, as well as contact sports.

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