Lateral Ankle Treatment

This is a randomized control trial of pediatric patients with acute lateral ankle avulsion fractures. Patients will be randomized into two groups: Standard of care treatment which includes booting with early range of motion and gradual weening from the boot and a Test treatment which includes a 6 week short-let cast. The purpose of the study is to test whether prolonged immobilization (casting) can help prevent the formation of a subfibular ossicle. The study consists of two patient visits.

Inclusion Criteria: * Ages 5-12 at time of enrollment * Diagnosis of first-time lateral ankle injury and an avulsion fracture visible on imaging who can be enrolled within 14 days of injury * Patient and parent/legal guardian must speak English or Spanish Exclusion Criteria: * Previous ipsilateral ankle surgery * Pre-existing musculoskeletal disease * If patient has been casted prior to confirmation of avulsion fracture on imaging * Developmental delay * Does not meet inclusion criteria