Management of ‘low-risk’ ankle fractures in children: a systematic review

'Low risk' ankle fractures are common among children, and include Salter-Harris Type I fractures, avlusion fractures, and non-displaced fractures. Optimal management of these injuries is unclear. In this study, the authors performed a meta-analysis of four randomized controlled trials. The trials compared various combinations of ankle brace, fibreglass cast, posterior splint, and elastic tubular bandage. The authors found high heterogeneity and high risk of bias among some studies. They did find a significantly faster return to school and higher functional scores with a brace compared to a cast.There was no significant difference in the use of analgesics. Overall, though the evidence is limited, the use of a brace which allows some range of motion exercises may improve function and expedite return to school.