60 pediatric patients with low-energy lateral ankle injuries were randomized to receive either a controlled ankle movement (CAM) boot (n=30) or a short leg walking cast (CAST; n=30). Outcomes of interest included range of motion, patient satisfaction, pain on the Wong-Baker Faces Scale, incidence of adverse events, time off school, time off work, Oxford Child Score (OCS), and the Oxford Parent Score (OPS). At 4 weeks, the CAM group showed significantly greater improvement in dorsiflexion, plantar flexion, and eversion when compared to the CAST group. The CAM group also had significantly higher satisfaction levels with notable improvements in OCS for difficulty running and sore/achy legs with significantly lower complication rates compared to the CAST group. All other outcomes were similar between the two groups. The findings of this trial suggest that CAM boots may offer superior outcomes in terms of ROM improvement, patient satisfaction, and reduced complications compared to traditional casts for ankle injury treatment.