Removable splints better than plaster casts for broken ankles

Australian researchers suggest that broken ankles possibly heal faster and better when instead of a plaster cast patients are fitted with removable splints or braces.

Ankle fractures are one of the most common fractures of the lower limb, especially in older women and young men and are usually treated by immobilising the joint in a plaster cast to protect the fracture.

Because of the fracture and the subsequent immobilisation period, people often experience pain, stiffness, weakness and swelling at the ankle, and have a reduced ability to participate in activities.

The team from the University of Sydney reviewed 31 studies and found that using a removable splint and doing exercises could give up to 20 per cent additional benefit by improving a patient's mobility in the long term following an ankle fracture.

A fixed cast does not allow for any exercise and causes the area to become itchy very quickly whereas removable splints or braces mean the ankles can be washed daily to relieve this.

The researchers believe that the benefits mainly arise from the exercise, which strengthens the broken joint and keeps it supple.

The researchers say for people who need ankle surgery, using a removable brace or splint after the surgery so that gentle ankle exercises can be performed may enhance the return to normal activities, reduce pain and improve ankle movement.

However, the incidence of adverse events, such as problems with the surgical wound, may be increased and accidents can happen if the patient fails to replace the splint immediately after washing and exercise.

They also say that the availability of removable splints is limited and plaster casts have the advantage of keeping the healing bones in compound or open fractures immobile.

The researchers say there is no evidence of improved function from other therapies such as electrotherapy, hypnosis or stretching.

A report on the study has been published in the journal Cochrane Database of Systematic Reviews.