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ankle fracture
fracture of the medial malleolus, lateral malleolus or talus
Management:
- surgical repair
- immobilization (orthopedic cast)
- close contact casting (molded, below-knee cast) as effective as internal fixation surgery in older adults (> 60 years) with acute, unstable ankle fracture [2]
- 3 weeks casting for stable fibular fractures non-inferior to 6 weeks [4]
- 3 year outcomes simlilar for casting vs surgery in older adults [3]
- rehabilitation after immobilization may not be of benefit [1]
Specific
talus fracture
General
bone fracture
References
- Moseley AM
Rehabilitation After Immobilization for Ankle Fracture.
The EXACT Randomized Clinical Trial.
JAMA. 2015;314(13):1376-1385.
http://jama.jamanetwork.com/article.aspx?articleid=2449186
- Willett K, Keene DJ, Mistry D et al
Close Contact Casting vs Surgery for Initial Treatment of
Unstable Ankle Fractures in Older AdultsA Randomized Clinical
Trial.
JAMA. 2016;316(14):1455-1463
PMID: 27727383
http://jamanetwork.com/journals/jama/article-abstract/2565749
- Sanders DW
Close Contact Casting vs Surgery for Unstable Ankle Fractures.
JAMA. 2016;316(14):1451-1452
PMID: 27727370
http://jamanetwork.com/journals/jama/article-abstract/2565734
- Keene DJ, Lamb SE, Mistry D et al
Three-Year Follow-up of a Trial of Close Contact Casting vs
Surgery for Initial Treatment of Unstable Ankle Fractures in
Older Adults.
JAMA. 2018;319(12):1274-1276
PMID: 29584832
https://jamanetwork.com/journals/jama/article-abstract/2676097
- Kortekangas T, Haapasalo H, Flinkkila T et al
Three week versus six week immobilisation for stable Weber B
type ankle fractures: randomised, multicentre, non-inferiority
clinical trial.
BMJ 2019;364:k5432.
PMID: 30674451
https://www.bmj.com/content/364/bmj.k5432