Adult cam narayan

Primary analysis was intention to treat; the randomised and observational cohorts were analysed separately.

Results From August 2010 to October 2013, 160 people were randomised (80 surgical and 80 non-surgical); 139 (71 surgical and 68 non-surgical) were analysed as intention to treat.

Participants willing to be randomised were randomly allocated to undergo surgical fixation followed by mobilisation in a walking boot for 6 weeks.

Exclusion criteria were participants who were medically unfit for anaesthesia/surgery; skeletally immature; previous trauma or surgery to the fractured ankle; inability to consent; pregnancy; the presence of comorbidities that impede mobilisation; and non-English speaking.

In this study involving participants with a 44-B1 ankle fracture, we sought to determine whether surgical management provided superior ankle function and quality of life at 12 months postinjury when compared with non-surgical management.

A concurrent observational cohort study was included to provide further evidence regarding the outcomes obtained in routine practice and to improve the generalisability of the results.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

See: fractures are common, with 1 in 800 people fracturing their ankle every year.1–3 The most common pattern involves a fracture of the distal fibula (lateral malleolus) at the level of the tibiofibular syndesmosis, otherwise known as an Association for the Study of Internal Fixation (AO) or Orthopaedic Trauma Association (OTA) type B ankle fracture.4–7 If combined with displacement of the ankle mortise or a fracture of the medial malleolus, surgical fixation is the preferred treatment.

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Participants not willing to be randomised formed the observational cohort.

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