← Evidence libraryAIR trial (cast vs brace for ankle fracture)
Use of cast immobilisation versus removable brace in adults with an ankle fracture: multicentre randomised controlled trial.
Kearney R, McKeown R, Parsons H, et al. BMJ (Clinical research ed.) 2021 · PMID 34226192 · doi:10.1136/bmj.n1506
Randomised trialManagementFracture clinic & non-operative careCitation checked
- Question
- In adults with ankle fractures, is a removable brace as good as a plaster cast for ankle function?
- Design
- Pragmatic multicentre RCT in UK NHS trauma units.
- Patients
- Adults with an acute ankle fracture suitable for cast immobilisation.
- Intervention
- Removable brace with immediate ankle range of movement exercises
- Comparison
- Below-knee plaster cast, with exercises started after cast removal
- Primary outcome
- Olerud-Molander Ankle Score at 16 weeks
- Key result
- Plaster casting was not superior to a removable brace: ankle function at 16 weeks did not differ significantly between groups, and secondary analyses were consistent.
- Limitations
- Unblinded, with a notable proportion of participants not completing follow-up.
- Impact on practice
- Supports using a removable brace or boot rather than a cast for adults with ankle fractures, allowing earlier movement and hygiene without loss of function.