Condition category
Date applied
Date assigned
Last edited
Prospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status
Results overdue

Plain English Summary

Background and study aims
Ankle fractures are common and many require surgery. After surgery, patients are managed in many different ways depending on their age, physical ability, fracture type, bone quality and surgeon. However, guidelines and evidence suggest that being able to actively move the ankle a couple of weeks after surgery in a removable boot might be beneficial to the patient. The two methods being compared are plaster cast and an Aircast® boot. Managing an ankle fracture with a plaster cast means that patients keep their injured ankle relatively still (immobilised) whilst managing an ankle fracture with an Aircast® boot means that patients can move their injured ankle quite soon after surgery – this is called early mobilisation. The findings of this study will be used to determine which treatment is best and which, if any, can be recommended as standard care for patients who fracture their ankles and need surgery.

Who can participate?
Adults that have recently had surgery for an ankle fracture.

What does the study involve?
Participants are randomly allocated into one of two groups. Those in group 1 are given a plaster cast. Those in group 2 are given a removable support boot. All participants then attend a clinic appointment 4 weeks later (6 weeks post-surgery) and assessments performed. Participants are asked to complete questionnaires at 5 weeks (7 weeks post- surgery) and (12 weeks post-surgery). Up to twenty patients are also asked to take part in telephone interviews to describe their experiences of their treatment. These data is compared between the two groups in order to evaluate which treatment is best in terms of function, quality of life, psychological, social, economic impact and patient experience as well as costs and benefits to the National Health Service, patients and society.

What are the possible benefits and risks of participating?
Whilst there are no immediate benefits for those people participating in the project, it is hoped that their participation will mean those in the future who experience a similar injury will receive the best/most appropriate treatment for their injury and will make the best use of NHS resources.

Where is the study run from?
Poole Hospital NHS Foundation Trust (lead site) and other NHS hospitals in the South East of England (UK)

When is the study starting and how long is it expected to run for?
February 2015 to April 2019

Who is funding the study?
National Institute for Health Research (UK)

Who is the main contact?
Mr Lee Tbaily

Trial website

Contact information



Primary contact

Mr Lee Tbaily


Contact details

Research & Innovation
Cornelia House
Poole Hospital NHS Foundation Trust
Longfleet Road
BH15 2JB
United Kingdom

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

Does early mobilisation after Ankle fracture surgery enhance Recovery? A pragmatic multi-centre randomised controlled Trial with qualitative component and health economic analysis comparing the use of plaster versus Aircast® boot.


ART V1.0

Study hypothesis

The aim of the study is to evaluate the relative effectiveness and cost-effectiveness of two methods of post-operative ankle fracture management (plaster versus Aircast® boot with range of movement) and to provide evidence-based recommendations for best care in clinical practice.

Ethics approval

NRES Committee South Central – Hampshire A, 22/12/2014, ref: 14/SC/1409

Study design

Randomised controlled trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type


Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Topic: Musculoskeletal, Surgery; Subtopic: Musculoskeletal (all Subtopics), Surgery; Disease: Musculoskeletal, Surgery


Current Interventions as of 06/12/2017:
1. Removable support boot: Removable boot with range of movement for four weeks
2. Plaster Cast: Plaster below knee i.e. immobilised for four weeks

Previous Interventions:
1. Aircast® boot: Aircast® boot with range of movement for four weeks
2. Plaster Cast: Plaster below knee i.e. immobilised for four weeks

Intervention type



Drug names

Primary outcome measure

Olerud and Molander Ankle Score; Timepoint(s): Five weeks post randomisation

Secondary outcome measures

1. Ankle functional data (range of movement, weight-bearing)
2. Standardised measure of general quality of life (EQ-5D-5L)
3. Healing status
4. Complications
5. Return to Usual Activities

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

1. Received surgery for fixation of unstable ankle fracture
2. Provision of informed consent to participate

Participant type


Age group




Target number of participants

Planned Sample Size: 246; UK Sample Size: 246

Participant exclusion criteria

1. Under 16 years old (skeletally immature)
2. Poor skin condition at operation site
3. Serious concomitant disease (e.g. stroke, osteoporosis, arthritis)
4. Diabetic neuropathy/other sensory neuropathy (lack of sensation)
5. Non-ambulatory prior to injury
6. Active leg ulceration
7. Patients who are unable to understand the study information or unable to complete the outcome questionnaires
8. Surgeon concerned about quality of fixation/integrity of wound
9. Fracture requiring further stabilisation in/around the ankle (e.g. syndesmosis).
10. Open ankle fracture (bone broken through skin)
11. Participant is a participant in other concurrent interventional research which may over-burden the participant or confound data collection
12. Concomitant injuries which will have a confounding effect on rehabilitation in the opinion of the investigator

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Poole Hospital NHS Foundation Trust
Dorset Research and Development Support Unit Cornelia House Longfleet Road
BH15 2JB
United Kingdom

Sponsor information


Poole Hospital NHS Foundation Trust

Sponsor details

Dorset Research and Development Support Unit
Cornelia House
Longfleet Road
BH15 2JB
United Kingdom

Sponsor type

Hospital/treatment centre



Funder type


Funder name

National Institute for Health Research

Alternative name(s)


Funding Body Type

government organisation

Funding Body Subtype

National government


United Kingdom

Results and Publications

Publication and dissemination plan

A number of scientific papers will be produced from the collated anonymised study data. Results will be published in peer reviewed journals aimed at both surgeons and physiotherapists (e.g. Annals of the Royal College of Surgeons, Journal of Bone and Joint Surgery and Physiotherapy. Papers will include messages about functional, socio-economic and psychological outcomes as well as the publication of the protocol. Results will also be published in the Health Service Journal, to authors of the Cochane review, and findings will be disseminated at conferences and via oral presentations at local, national and international trauma/orthopaedic and physiotherapy meetings. Participants and the general public will also be informed via via flyers, posters, Bournemouth University Clinical Research Unit website, Bournemouth University Research Blog, Twitter, podcast, press releases to the media.

IPD sharing statement:
The data sharing plans for the current study are unknown and will be made available at a later date

Intention to publish date


Participant level data

To be made available at a later date

Basic results (scientific)

Publication list

Publication citations

Additional files

Editorial Notes

04/10/2018: The following changes have been made to the trial record: 1. The recruitment end date has been changed from 30/08/2018 to 31/08/2018 2. The intention to publish date has been added 3. Participant level data has been changed from "Not provided at the time of registration" to "To be made available at a later date" 4. The IPD sharing statement has been added 06/12/17: The following changes were made: 1. Recruitment end date was changed from 30/09/2017 to 30/08/2018. 2. Overall trial end date was changed from 31/03/2018 to 30/04/2019. 3. Contact address and intervention were updated.