Orthopaedic management in adults with ankle fracture may involve reduction, surgical fixation, and immobilisation for six to 12 weeks depending on the severity of the fracture. It is usually caused by low-velocity trauma such as falls, twisting injuries and sports injuries, and therefore is prevalent in not only the older, but also the young and active population.
The incidence is between 107 and 184 per 100,000 person-years, making it one of the most common lower limb fractures.
LATERAL MALLEOLUS FRACTURE REHABILITATION PROTOCOL BRIGHAM TRIAL
Results from this trial will contribute to an evidence-based approach for rehabilitation after ankle fracture.Īnkle fracture refers to fracture of the medial or lateral malleolus or the distal tibia or fibula. It uses a pragmatic design to reflect clinical practice and maximise generalisability. This trial incorporates features known to minimise bias. The primary conclusions will be based on the four-week follow-up data. To test the effects of treatment, between-group differences will be examined with analysis of covariance using a regression approach. Data on the use of physiotherapy services and participants' out-of-pocket costs will be collected for the cost-effective and cost-utility analyses. Secondary outcomes will include measures of impairments, activity limitation and participation. The primary outcome measures will be the Lower Extremity Functional Scale and the Assessment of Quality of Life. Blinded follow-up assessments will be conducted four, 12 and 24 weeks after randomisation. Participants in the treatment group will also receive joint mobilisation twice a week for four weeks.
All participants will perform an exercise programme.
Ninety participants will be recruited from the physiotherapy departments of three teaching hospitals and randomly allocated to treatment or control groups using a concealed procedure. The primary aim of this trial is to determine if adding joint mobilisation to a standard exercise programme is effective and cost-effective after cast immobilisation for ankle fracture in adults. Passive joint mobilisation is a technique frequently used by physiotherapists to reduce pain, improve joint movement and facilitate a return to activities after injury, but its use after ankle fracture is currently based on limited evidence.
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