The effects of shared decision making in the conservative management of stable XXXX .

@entity1 @entity174 @entity1171 @entity1031 @entity158 @entity272 @entity579 @entity2693
INTRODUCTION: The majority of @entity1171 seen in clinic are stable, will not displace and do not require plaster casting to achieve union in a good position. Nevertheless, many @entity1 with stable @entity1171 are advised that they need a cast. In this study we counseled @entity1 regarding the different options for conservative management of their stable @entity1171 . We then encouraged them to make an informed decision on which method of treatment they would like to pursue. MATERIALS AND METHODS: We analyzed eight years of a single consultant's @entity174 clinic. 163 @entity1 were offered a choice of: a weight bearing below knee cast; a functional ankle brace; or a regime of rest, ice, compression bandage and elevation (" @entity579 " regime). All @entity1 were advised to mobilize on the injured ankle as their @entity158 allowed. RESULTS: 163 @entity1 were suitable for all 3 treatment options. 82% (133/163) chose an ankle brace, 15% (25/163) opted for a @entity579 regime and 3% (5/163) chose a below knee cast. Of these only one returned to clinic complaining of @entity158 , however after further discussion the @entity1 opted to continue with his @entity579 regime as planned. DISCUSSION: A conservative approach to these injuries is now common practice; however there is a wide variation in what type of conservative management is given. Recent studies suggest orthopedic surgeons are still treating the majority of these injuries with a weight-bearing cast despite risks of @entity2693 , @entity272 and @entity1031 . This study showed when the @entity1 is given opportunity to make an informed choice the vast majority opt not to have a cast. The study suggests management of these injuries should be decided via a two-way conversation between @entity1 and practitioner. CONCLUSIONS: Using a shared decision making approach to these injuries is a useful method of providing @entity1 with the most suitable treatment for their personal treatment goals.
