Methodology: 4/5
Usefulness: 3.5/5

Kortekangas T, et al. BMJ. 2019 Jan 23;364:k5432

Question and Methods: This is a pragmatic, randomized, controlled trial to determine if 3 weeks of immobilization (in cast or orthosis) is non-inferior to usual treatment (6 weeks cast immobilization) for stable Weber B ankle fractures

Findings: Immobilization for 3 weeks with a cast or orthotic is NOT inferior to usual care in terms of OMA scores of ankle function at 1 year. 3-week orthotics showed significant improvement in range of motion and lower rates of DVTs.

Limitations: Patient factors that can influence fracture healing were not considered

Interpretation: 3 weeks of immobilization by cast or a simple orthotic for stable Weber B ankle fractures is no worse than traditional care

By: Dr. Erica Lee

Hans Rosenberg
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.