Wednesday, July 14, 2021 (Health Day News)-New research shows that modern, flexible boots may be as good as old-fashioned plaster casts when it comes to treating ankle fractures.

According to the American Academy of Orthopaedic Surgeons, ankle fractures are usually related to sports, traffic accidents, or falls. They may be simple fractures of a single bone or more complex fractures involving multiple bones. Ankle fractures do not always require surgery, but most people need to fix their feet in a cast or removable boots for about six weeks so that the bones can heal.

People in the new study reported similar levels of pain and function after 16 weeks, regardless of whether they received a cast or detachable boot to treat their ankle fracture.

Study author Rebecca Kearney, Professor of Trauma and Orthopedic Rehabilitation at the University of Warwick, Coventry, UK, said: “Fixing a broken ankle in a plaster is no better than moving it.”

She said that many people prefer braces. She pointed out: “Functional braces can be removed for early exercise and allow patients to take care of their skin and basic hygiene.” In contrast, casts are rigid and can cause joint stiffness and muscle weakness.

As part of the trial, approximately 670 people with broken ankles received under-knee casts or removable braces. People wearing the brace were told how and when to take off their boots and asked to perform ankle strengthening exercises.

After approximately four months of follow-up, the patient was asked about pain during walking, climbing stairs, running, jumping, and squatting, as well as stiffness, swelling, and pain when using any support devices. Their answers were incorporated into the Olerud Molander ankle score.

Bottom line? There was no difference in scores between the two groups. "When choosing a cast or brace, you need to consider the patient's preferences and costs," Kearney said.

The research was published online on BMJ on July 6.

Dr. Andrew Elliott is a foot and ankle surgeon at the New York City Special Surgery Hospital. He said that in the treatment of ankle fractures, casts and detachable boots have advantages.

"This ultimately becomes a discussion between patients and surgeons about what they think is the best treatment option," said Elliott, who has nothing to do with this new study.

The new research does show that those who wear boots are more likely to be infected and/or require further surgery, but it is not specifically designed to address these issues, so no conclusions can be drawn. However, this does make sense, he said.

"These wounds may occur during early exercise, and the boots do not fit like a cast, so you may have minor trauma and wound problems," Elliott explained.

The American Academy of Orthopaedic Surgeons provides more information on how to treat ankle fractures.

Source: Rebecca Kearney, PhD, Professor of Traumatology and Orthopedics Rehabilitation, Deputy Director of the Warwick Clinical Trials Group, University of Warwick, Coventry, UK; Andrew Elliott, MD, Foot and Ankle Surgeon, New York City Special Surgery Hospital; BMJ, July 6, 2021 Day, online