Clinical Audit of the Management of Stable Ankle Fractures

INTRODUCTIONAnkle fractures are common and ‘stable’ ankle fractures comprise 40–75% of this group. Studies show that these injuries can be managed successfully in a functional brace, with no need for further radiographs and minimal out-patient follow-up. We aimed to audit current practice and introduce change in order to improve treatment and produce financial savings. PATIENTS AND METHODSA retrospective 6-month audit was carried out to establish practice. Guidelines were then drawn up and widely distributed in the accident and emergency (A&E) and orthopaedic departments. These included criteria for diagnosis of stable ankle fractures, a management protocol for treatment of these injuries in a brace and also a follow-up algorithm in the out-patient clinic. A prospective 6-month audit was then carried out to assess the effectiveness of the guidelines. RESULTSOf patients presenting in the second 6-month period, 91% were managed in a functional brace. The mean number of out-patient follow-up appointments, we...