Date Added: 14/09/2017

Date Updated: 14/09/2017

Close contact casting versus surgery for initial treatment of unstable ankle fractures in older adults

Stage of development: Established

Stage of EAA: Assessment Complete

Description, patients and keywords:

This Brief considered evidence for the safety, effectiveness and cost-effectiveness of close contact casting (CCC) compared to open reduction with internal fixation (ORIF) surgery as first-line treatments for unstable ankle fracture among the older adult population.

Although there was no difference in outcomes at 6-months between patients who received conventional open reduction with internal fixation compared to close contact casting, a significant number of close contact casting patients (20%) failed treatment and needed to undergo ORIF. In addition, there was an increased risk of thromboembolism in patients who underwent close contact casting. Close contact casting is unlikely to be cost-effective and may result in poorer outcomes for many patients.