Non-operative treatment

For patients allocated to non-operative treatment, the injured ankle was placed in a standard, padded below the knee synthetic cast by a trained plaster technician. The ankle joint was immobilized at 90° angle (figure 3). Participants received guidance from a physiotherapist on walking with crutches. Immediate partial weigh-tbearing (approximately 15–20 kg) was permitted after the application of the cast and patients were instructed to start full weight-bearing (as tolerated) at 4 weeks after the injury.

A standard, padded below the knee synthetic cast made by a trained plaster technician. Cast is applied from the tuberosity of the tibia to the base of the toes and is lined and padded. The cast is applied with the ankle joint placed at 90° angle (neutral dorsiflexion).