Bracing After Ankle Fracture

NCT ID: NCT07163091

Last Updated: 2025-09-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

1400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-31

Study Completion Date

2029-09-30

Brief Summary

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Ankle fractures are common, debilitating and usually treated with immobilisation using a foot-ankle brace (walker). Emerging evidence suggests that a less restrictive brace may reduce recovery time without increasing the risk of complications, and patients tend to prefer ankle stirrups. However, evidence supporting their non-inferiority remains limited and inconclusive. Thus, the aim is assess if an ankle stirrup is non-inferior to a standard walker in reducing pain and function measured by the Manchester-Oxford Foot Questionnaire (MOXFQ) three months after ankle fracture. The hypothesis is that ankel stirrups align better with patients preferenes for less immobilising braces and offer sufficient stability while the fracture heals. Secondarily it may lead to faster recovery of function, return to work and reduced cost. The sample size of a maximum of 1400 patients allow us to assess non-inferiority in age and sex specific subgroups and treatment (surgical or non-sugical). Non-inferiority will be assessed in a pragmatic, multicenter, randomised controlled trial involving Scandinavian orthopedic departments.

Detailed Description

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Ankle fractures are the third most occuring fracture. After an ankle fracture, patients experience reduced ankle function and pain \[3\]. Also, evidence with moderate to high risk of bias indicate that immobilisation prolong patients recovery. However, high quality evidence are necessary for finite conclusions.

In Scandinavia, foot-ankle braces (walkers) are used to immobilise the fracture while healing. Even though patients acknowledge the need for immobilisation, a qualitative study of ten patients found that patients experienced difficulties in adhering to the recommendation of immobilisation after ankle fracture. A randomised controlled trial (RCT) by Smeeing et al. 2020 found that braces and elastic bands that allow more ankle movement than walkers did not lead to poorer functional outcomes (p=0.56), but may lead to a faster return to work (p = 0.02) without increased complications (p=0.63). The RCT was terminated when half the sample had been included, thus questioning the statistical power of the findings. Based on patient interviews completed during trial preparations we learned that patients preferred ankle stirrups as they allowed movement during use. The same patients also expressed an aversion to the walker, while being hesitant that ankle-supporting elastic bandages provided sufficient support.

Compared to the walker, ankle stirrups may better align with patient preferences while remaining non-inferior in restoring ankle-related outcomes such as pain and function.

Patients will be included in the orthopedic outpatient departments and randomised to a walker or an ankle stirrup. Randomisation will be in blocks to ensure that surgically and non-surgically patients are evenly distributed between groups and that each center will have an equal amount of intervention and control patients. Weightbearing will be unrestricted in both groups so the difference will be the brace (ankel stirrup or walker). Other variation will be a reflection of usual practice. The primary outcome is a validated score including pain, function and social interaction 12 weeks after ankel fracture. The sample size is calculated to 140 patients per each of six subgroups (males 18-39, females 18-39, males 40-59, females 40-59, males 60+, females 60+) randomisation stop when the smallest subgroup (females 18-39 years) reaches 140 or a maximum of 1400 has been included. Patients have been involved in designing the trial and a former ankle fracture patient serves a member of the steering committee.

Conditions

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Ankle Fracture Rehabilitation Recovery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators
The data collection is blinded at baseline assessment for the local project managers. The researchers will be blinded to treatment allocation until reporting.

Study Groups

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foot ankel brace (walker)

Walker: immobilisation during use

Group Type ACTIVE_COMPARATOR

Foot-ankel brace (walker)

Intervention Type OTHER

Walkers immobilise and stabilise the ankle during weightbearing.

Ankel stirrup

Ankel stirrup: active ankel dorsal and plantar flextion during use

Group Type EXPERIMENTAL

ankel stirrup

Intervention Type OTHER

Ankel stirrups are a patient preferred ankel brace that allow active ankle dorsal and plantar flexion during weightbearing while maintaining lateral stability.

Interventions

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ankel stirrup

Ankel stirrups are a patient preferred ankel brace that allow active ankle dorsal and plantar flexion during weightbearing while maintaining lateral stability.

Intervention Type OTHER

Foot-ankel brace (walker)

Walkers immobilise and stabilise the ankle during weightbearing.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* 18 years or older
* Surgically or non-surgically treated ankle fracture

Exclusion Criteria

* Pathological fractures
* Inadequacy to read or speak danish
* Open fractures
* Prolonged need for immobilisation (e.g. non-union or insufficient wound healing)
* Inability to adhere to trial procedures (e.g. neuropathy or severe psychiatric disorder)
* Restricted weightbearing
* Uninterest in participating
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Aalborg University Hospital

OTHER

Sponsor Role collaborator

Randers Regional Hospital

OTHER

Sponsor Role collaborator

Aarhus University Hospital

OTHER

Sponsor Role collaborator

Viborg Regional Hospital

OTHER

Sponsor Role collaborator

Hospital of Southern Jutland, Aabenraa, Denmark

UNKNOWN

Sponsor Role collaborator

Slagelse Hospital

OTHER

Sponsor Role collaborator

Bispebjerg Hospital

OTHER

Sponsor Role collaborator

Hvidovre University Hospital

OTHER

Sponsor Role collaborator

Herlev Hospital

OTHER

Sponsor Role collaborator

National Hospital of the Faroe Islands

OTHER_GOV

Sponsor Role collaborator

Hospital of South West Jutland, Esbjerg, Denmark

UNKNOWN

Sponsor Role collaborator

Køge Hospital, Denmark

UNKNOWN

Sponsor Role collaborator

Sygehus Lillebaelt

OTHER

Sponsor Role collaborator

Odense University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Bjarke Viberg, Phd

Role: STUDY_CHAIR

Odense Universitetshospital Ortopaedkirurgisk Afdeling

Locations

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Orthopedic Department, Hospital of Southern Jutland

Aabenraa, , Denmark

Site Status

Orthopedic Department, Aalborg Universitets Hospital

Aalborg, , Denmark

Site Status

Orthopedic Department, Aarhus University Hospital

Aarhus, , Denmark

Site Status

Orthopedic Department, Bispebjerg Hospital

Copenhagen, , Denmark

Site Status

Orthopedic Department, Hospital of South West Jutland

Esbjerg, , Denmark

Site Status

Orthopedic Department, Herlev Hospital

Herlev, , Denmark

Site Status

Orthopedic Department, North Zealand Hospital

Hillerød, , Denmark

Site Status

Orthopedic Department, Hvidovre Hospital

Hvidovre, , Denmark

Site Status

Orthopedic Department, Hospital Lillebaelt - Kolding

Kolding, , Denmark

Site Status

Orthopedic Department, Zealand University Hospital - Køge

Køge, , Denmark

Site Status

Orthopedic Department, Odense University Hospital

Odense, , Denmark

Site Status

Orthopedic Department, Randers Hospital

Randers, , Denmark

Site Status

Orthopedic Department, Slagelse Hospital

Slagelse, , Denmark

Site Status

Orthopedic Department, Hospital Lillebaelt - Vejle

Vejle, , Denmark

Site Status

Orthopedic Department, Viborg Hospital

Viborg, , Denmark

Site Status

Surgical Centre, National Hospital of the Faroe Islands

Tórshavn, , Faroe Islands

Site Status

Countries

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Denmark Faroe Islands

Central Contacts

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Jonas A Ipsen, phd

Role: CONTACT

+4523925264

Bjarke Viberg, Phd

Role: CONTACT

Facility Contacts

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Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, Phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Jonas A Ipsen, phd

Role: primary

+4523925264

Other Identifiers

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10.46540/4308-00191B

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

OP_2497/OT_0001

Identifier Type: -

Identifier Source: org_study_id

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