Texas Scottish Rite Hospital for Children
This is a randomized control trial of pediatric patients with acute lateral ankle avulsion fractures. Patients will be randomized into two groups: Standard of care treatment which includes booting with early range of motion and gradual weening from the boot and a Test treatment which includes a 6 week short-let cast. The purpose of the study is to test whether prolonged immobilization (casting) can help prevent the formation of a subfibular ossicle. The study consists of two patient visits.
This is a randomized control trial for pediatric patients who present to Scottish Rite for an acute lateral ankle avulsion fracture. Patients will be randomized into standard of care treatment or prolonged immobilization (test treatment). Standard of care treatment is booting with early range of motion or test treatment and gradually weaning from the boot. Test treatment (prolonged immobilization) is 6 weeks of immobilization in the form of a short-leg cast. The purpose is to see if prolonged immobilization will promote healing of the avulsion fracture and prevent the formation of a subfibular…
Inclusion Criteria: * Ages 5-12 at time of enrollment * Diagnosis of first-time lateral ankle injury and an avulsion fracture visible on imaging who can be enrolled within 14 days of injury * Patient and parent/legal guardian must speak English or Spanish Exclusion Criteria: * Previous ipsilateral ankle surgery * Pre-existing musculoskeletal disease * If patient has been casted prior to confirmation of avulsion fracture on imaging * Developmental delay * Does not meet inclusion criteria
Patients will be treated with a non-weightbearing short-leg cast for 6 weeks to promote avulsion fracture healing. This will be followed physical therapy, and a gradual return to activity.
Patients will receive brief immobilization (boot) as needed, followed by early range of motion exercises. Physical therapy and a return-to-activity plan will be implemented as symptoms allow.
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