Improvement in the treatment of stable ankle fractures: an audit based approach.

Stable ankle fracture patients form a distinct, clinically benign group in which functional treatment can be used. An initial retrospective audit of the fracture clinic records of our institution for 1 calendar year demonstrated that recognition and functional treatment of stable ankle fractures was rarely followed. After the introduction of formal departmental evidence-based guidelines, subsequent audits have showed progressive improvements with significant reductions of time spent immobilised in plaster, time spent non-weight bearing and number of routine check radiographs, without compromising patient safety. This study illustrates the value of evidence-based guidelines in maintaining high standards of care over time.