{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:08:53Z","timestamp":1793408933951,"version":"4.5.0"},"reference-count":34,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,6,1]]},"abstract":"<jats:p>OBJECTIVES. Isolated distal fibular ankle fractures in children are very common and at very low risk for future complications. Nevertheless, standard therapy for these fractures still consists of casting, a practice that carries risks, inconveniences, and use of subspecialty health care resources. Therefore, the main objective of this study was to determine whether children who have these low-risk ankle fractures that are treated with a removable ankle brace have at least as effective a recovery of physical function as those that are treated with a cast.<\/jats:p>\n               <jats:p>METHODS. This was a noninferiority, randomized, single-blind trial in which children who were 5 to 18 years of age and treated in a pediatric emergency department for low-risk ankle fractures were randomly assigned to a removable ankle brace or a below-knee walking cast. The primary outcome at 4 weeks was physical function, measured by using the modified Activities Scale for Kids. Additional outcomes included patient preferences and costs.<\/jats:p>\n               <jats:p>RESULTS. The mean activity score at 4 weeks was 91.3% in the brace group (n = 54), and this was significantly higher than the mean of 85.3% in the cast group (n = 50). Significantly more children who were treated with a brace had returned to baseline activities by 4 weeks compared with those who were casted (80.8% vs 59.5%). Fifty-four percent of the casted children would have preferred the brace, but only 5.7% of children who received the brace would have preferred the cast. The cost-effectiveness acceptability curve was always &amp;gt;80%; therefore, the brace was cost-effective compared with the cast.<\/jats:p>\n               <jats:p>CONCLUSIONS. The removable ankle brace is more effective than the cast with respect to recovery of physical function, is associated with a faster return to baseline activities, is superior with respect to patient preferences, and is also cost-effective.<\/jats:p>","DOI":"10.1542\/peds.2006-2958","type":"journal-article","created":{"date-parts":[[2007,6,1]],"date-time":"2007-06-01T16:36:04Z","timestamp":1180715764000},"page":"e1256-e1263","source":"Crossref","is-referenced-by-count":94,"title":["A Randomized, Controlled Trial of a Removable Brace Versus Casting in Children With Low-Risk Ankle Fractures"],"prefix":"10.1542","volume":"119","author":[{"given":"Kathy","family":"Boutis","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine"},{"name":"Population Health Sciences, Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Willan","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Babyn","sequence":"additional","affiliation":[{"name":"Divisions of Diagnostic Imaging"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Unni G.","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Research Institute"},{"name":"Orthopedic Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Alman","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Schuh","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine"},{"name":"Population Health Sciences, Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2007,6,1]]},"reference":[{"key":"2021120902082444800_R1","unstructured":"Anderson A. 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