Interventions for treating ankle fractures in children

Yeung, Denise; Jia, Xueli; Miller, Clare; Barker, Simon

doi:10.1002/14651858.cd010836.pub2

Cited by 11 publications

(9 citation statements)

References 63 publications

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“…The regression model indicates that, if this trend continues, there will be about three times more low-trauma ankle fractures in Finland in the year 2030 than there was in 2000.³ In children ankle fractures occur in about 1 per 1000 per year. 4 , 5 Ankle fractures have a bimodal age distribution with peaks in younger males and older females.⁶ There has been three-fold increase in the incidence amongst elderly females over the past three decades.⁷ In addition, amongst multiply injured patients foot injuries are prognostically important: those who survive their injuries are far more impaired functionally if they have a foot injury in addition to multisystem trauma. 8 , 9 Ankle fractures result in significant morbidity in adults, with prognosis worsening with increasing age.¹⁰ They usually result from indirect traumas.…”

Section: Ethical Publication Statementsmentioning

confidence: 99%

Randomized controlled trial of multidisciplinary rehabilitation therapy using mobile applications in cases of ankle fractures

et al. 2022

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A multidisciplinary approach to rehabilitation in patients with ankle fractures is needed to return to their daily activities. Mobile health applications can improve or optimize the rehabilitation process. The purpose of this study is to monitor the efficiency of a modified and validated rehabilitation scheme for the functional rehabilitation of the lower limbs. The subjects of the study are patients in the post-immobilization and post-operative period. The algorithm of procedures administered to the patients were performed by physiotherapists and monitored via mobile apps. The results show a reduction of the swelling and the pain, overcoming the muscular imbalance, enhanced stabilization, correct way of walking, and an improved quality of life of the patients with ankle fractures. Despite a certain trend towards residual deficit, the implementation of kinesitherapeutic means creates the necessary background on the basis of which specialized methods can be applied – joint-mobilizing techniques and passive stretching, for the purpose of the full recovery of the functions of the lower extremity. The application of mobile apps optimizes the recovery process and increases access to rehabilitation.

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Section: Ethical Publication Statementsmentioning

confidence: 99%

Randomized controlled trial of multidisciplinary rehabilitation therapy using mobile applications in cases of ankle fractures

et al. 2022

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“…There are six Cochrane reviews that have evaluated the literature supporting the management of childhood fractures 3–8. The reviews have identified 45 trials with sufficient quality to inform practice, with most trials relating to the management of wrist fractures.…”

Section: Introductionmentioning

confidence: 99%

“…The reviews have identified 45 trials with sufficient quality to inform practice, with most trials relating to the management of wrist fractures. Only two reviews were able to draw firm conclusions due to a paucity of randomised trials in children’s fracture care, despite the relative high frequency of these injuries 5 7…”

Section: Introductionmentioning

confidence: 99%

CORE-Kids: a protocol for the development of a core outcome set for childhood fractures

Marson¹,

Manning²,

James³

et al. 2020

BMJ Open

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IntroductionLimb fractures in children are common yet there are few trials that compare treatments for these injuries. There is significant heterogeneity in the outcomes reported in the paediatric orthopaedic literature, which limits the ability to compare study results and draw firm conclusions. The aim of the CORE-Kids Study is to develop a core outcome set for use in research studies of childhood limb fractures. A core outcome set will provide a minimum set of outcomes to be measured in all trials to minimise the heterogeneity of outcomes reported and minimise reporting bias. A core outcome set ensures that outcomes are reported that are relevant to families as well as clinicians. The core outcome set will include additional upper and lower limb modules.MethodsThe development of the core outcome set will require four phases to evaluate:What are the outcomes that are relevant to professionals?What are the outcomes that are relevant to families?What are the most important of these outcomes?Which outcomes should be included in the core outcome set?This will be completed through a systematic review of trials to identify the outcomes domains that are relevant to trialists. A series of semi-structured interviews will be completed with families to identify the outcome domains that are relevant to families. These outcome domains will be used in a three-round Delphi Study to analyse the importance of these outcome domains to a range of stakeholders including parents, clinicians and researchers. Following this, the core outcome set will be decided at a consensus meeting.Ethics and disseminationEthical approval has been awarded HRA/REC IRAS number 262503. Date of approval 06/08/2019. Dissemination will be through scientific literature and international societies.Trial registrationCore Outcome Measures in Effectiveness Trials Initiative, registration number: 1274. Date of registration 13/12/2018.PROSPERO registration numberCRD42018106605.

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“…Evidence is limited for the use of removable immobilization, such as Controlled Ankle Motion (CAM) boot, versus short leg walking casts (CAST) for these injuries. In the recent Cochrane reviews of Pediatric Ankle Fractures, 3 studies discussed removable immobilization versus plaster or fiberglass casting for these injuries 5–8 . All 3 studies concluded that removable immobilization is more effective and results in faster recovery of physical function, greater family and patient satisfaction, and is less costly than traditional casting 6–8 .…”

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confidence: 99%

Controlled Ankle Movement (CAM) Boot Provides Improved Outcomes With Lower Complications Than Short Leg Walking Cast in Low-energy Pediatric Lateral Ankle Injuries: A Prospective, Randomized Study

Beck

Kang

Bennett

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Low-energy lateral ankle injuries (Salter-Harris 1 distal fibula, distal fibula avulsion fractures, and radiograph-negative lateral ankle injuries) are common in pediatric patients. Patient-based outcomes for the 2 treatment options, short leg walking cast (CAST) and controlled ankle motion (CAM) boot, are unknown. This study aims to determine differences between 2 treatments of low-energy lateral ankle injuries in pediatric patients. Methods: A prospective, randomized controlled trial comparing the acute outcomes of CAST and CAM treatment for low-energy lateral ankle injuries in pediatric patients was completed. Patients were evaluated in-person at presentation and 4 weeks for ankle range of motion and Oxford foot and ankle score. A novel survey defining patient and parent satisfaction and time away from school/work was also completed. Treatment complications were documented. Patients were called at 8 weeks postinjury to determine other complications and the final time of return to sport. Mixed effects linear regression models evaluated change over time between the 2 treatment groups. Results: After 60 patients were enrolled, 28 patients in the CAST group and 27 patients in the CAM group completed the study. Males comprised 51% (28), with 38 (69%) patients identifying as Hispanic. The patient’s average age was 11.3±2.9 years and the average body mass index was 23. At the 4-week evaluation, the CAM group had improved range of motion, higher satisfaction scores (5.26 CAM vs. 4.25 CAST, P<0.05), similar pain scores (0.32 CAST vs. 0.41 CAM, P=0.75), and lower complications (0.54/patient CAST vs. 0.04/patient CAM, P<0.0001) than the CAST group. Female patients had improved inversion with CAM treatment than males (P<0.05). Patients over age 12 in the CAST group had significantly decreased plantarflexion at week 4 (P=0.002). Improvement in Oxford scores was similar between the CAST and CAM groups between the initial presentation and 4 weeks, except for increased improvement in CAM group Oxford scores for difficulty running and symptoms with walking/walking. At the 8-week evaluation, patients in the CAST group had a higher rate of continued symptoms than the CAM group (15.4% vs. 0%) Conclusions: CAM boot treatment of low-energy lateral ankle injuries in pediatric patients results in improved results and lower complications than CAST treatment. Level of Evidence: Level I —randomized, controlled trial with a statistically significant difference.

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Interventions for treating ankle fractures in children

Cited by 11 publications

References 63 publications

Randomized controlled trial of multidisciplinary rehabilitation therapy using mobile applications in cases of ankle fractures

Randomized controlled trial of multidisciplinary rehabilitation therapy using mobile applications in cases of ankle fractures

CORE-Kids: a protocol for the development of a core outcome set for childhood fractures

Controlled Ankle Movement (CAM) Boot Provides Improved Outcomes With Lower Complications Than Short Leg Walking Cast in Low-energy Pediatric Lateral Ankle Injuries: A Prospective, Randomized Study

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