AIR - Ankle Injury Rehabilitation

• Research type

  Research Study

• Full title

  Ankle Injury Rehabilitation - A multi-centre randomised controlled trial to assess the difference between plaster cast and functional bracing in the management of ankle fractures.

• IRAS ID

  223251

• Contact name

  Rebecca Kearney

• Contact email

  r.s.kearney@warwick.ac.uk

• Sponsor organisation

  University of Warwick

• Duration of Study in the UK

  4 years, 11 months, 23 days

• Research summary

  Research Summary:
  Ankle fractures represent 9% of the trauma workload and demand is increasing. A threefold increase is expected by 2030 due to an increase in older adults who are remaining active. The frequency of this injury is an increasing burden on the NHS year on year. The short-term impact of this injury results in physical impairments of pain, stiffness, weakness and swelling. The longer-term impact results in prolonged time off work, development of posttraumatic arthritis and psychological consequences of depression and anxiety.
  Ankle fractures that occur below the level of the syndesmosis are considered ‘stable’ and are usually treated with functional braces. All other ankle fractures are less stable, with some requiring open reduction and internal fixation (ORIF) with the aim of restoring stability.
  Regardless of the decision to operate or not, the immediate management has traditionally been plaster cast immobilisation for several weeks, whilst the bone heals. A cast provides maximum support; however, there are potential problems. Firstly, there is the immediate impact on mobility for a period of around six weeks. Secondly, there are the risks associated with prolonged immobilisation: muscle atrophy, deep vein thrombosis and joint stiffness. Finally, there are the long-term consequences, which include prolonged gait abnormalities, persistent calf muscle weakness and an inability to return to previous activity levels. Alternative functional bracing may potentially address these issues. However, it does not provide the same degree of support to the healing bones.This is a UK multi-centre, randomised controlled trial. All adults with a fractured ankle under the care of a clinician at any of the named recruiting sites are potentially eligible. New patients with an ankle fracture are reviewed each day by the trauma team and will be randomised to receive either a cast or a functional brace/fixed angle removable orthotic (FARO).

  Smmary of Results:
  https://eur03.safelinks.protection.outlook.com/?url=http%3A%2F%2Furl6570.hra.nhs.uk%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbc-2FvbT-2BNq7-2BzZf-2FlpsyQrgBFVtnGkYOKSQju-2FjFDTw7FaIDM1phHfzvrXvay0zGN5ZMSIe02fuRNsQ-2Bpn8HSSvh-2FVWUZGht6a18H7AgnGWazqRBfoFPz0qp5dz2-2FbGt-2FTYdTCVY0zzneGNR4WtHMwL8-3DHJZI_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YKYYthkukB9dhOjc4QvnvkjvLfTcYfcK-2F3-2FV4vqs8PgmtFewt5ecESYYe4y-2FYopBwsfsEnGvV8HVhTY08mLOf3MRgQMFaUgVqLjYQI0ARn0dE2-2FHBcunotSfMBbkhunDxRGYH3Exrd2ypmIYaV8bxEjDYR7Gqcyz7OTQM6zXimc6g-3D-3D&data=04%7C01%7Capprovals%40hra.nhs.uk%7Cdbcd9f5212864f25d00008da05c964b1%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C637828660135956340%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&sdata=ZgrNRQ8yMrLUWiSRE2vV5bBCZH47hZtAP76AUqqCkzw%3D&reserved=0

• REC name

  West Midlands - Edgbaston Research Ethics Committee

• REC reference

  17/WM/0239

• Date of REC Opinion

  4 Jul 2017

• REC opinion

  Further Information Favourable Opinion