Six hundred sixty-nine patients with acute ankle fractures were randomized to receive either a plaster cast (n=334) or a fixed-angle removable brace (n=335) following operative or nonoperative initial management. The primary outcome of interest was ankle function, measured using the Olerud-Molander Ankle Score (OMAS). Secondary outcomes included quality of life (EuroQol five-dimension five-level questionnaire), disability (Disability Rating Index), and complications. Outcomes were assessed at 16 weeks, 24 weeks, and two years. Overall, the study found no significant differences in ankle function between the two groups at two years. Quality of life and disability outcomes were also similar. These findings suggest that a removable brace is an effective alternative to a plaster cast for immobilization in ankle fracture management.