Interventions for treating ankle fractures in children

Area of Science:

• Pediatric Orthopedics
• Sports Medicine
• Evidence-Based Medicine

Background:

• Ankle fractures are common in children, often resulting from twisting injuries.
• Treatment ranges from casting for minor fractures to surgical fixation for severe ones.
• Current evidence on optimal treatment for pediatric ankle fractures is limited.

Purpose of the Study:

• To evaluate the benefits and harms of different interventions for treating ankle fractures in children.
• To synthesize findings from randomized controlled trials on pediatric ankle fracture management.

Main Methods:

• Systematic search of multiple databases including Cochrane, MEDLINE, EMBASE, and CINAHL.
• Inclusion of randomized and quasi-randomized controlled trials on pediatric ankle fracture interventions.
• Independent screening, risk of bias assessment, and data collection by two reviewers; no meta-analysis performed.

Main Results:

• Three trials (189 children) with high risk of bias compared non-surgical options for low-risk ankle fractures.
• Ankle braces showed low-quality evidence of improved function at four weeks compared to rigid casts.
• Some evidence suggests earlier return to activity with braces, and greater patient preference for braces over prolonged casting.

Conclusions:

• Low-quality evidence suggests ankle braces may improve functional recovery in children with low-risk ankle fractures compared to rigid casts.
• Significant lack of high-quality randomized controlled trial evidence exists for pediatric ankle fracture treatment.
• Further research is crucial to address priority questions in managing these common childhood injuries.