Cast Immobilization is Non-inferior to Surgery for Unstable Weber B Ankle Fractures: Results from the SUPER-FIN Trial

MedXY Editorial Team•Jan 21, 2026•Emergency Medicine

Cast immobilization demonstrated non-inferiority to open reduction and internal fixation (ORIF) for Weber B fractures that are stable on static radiographs but unstable under stress testing.
At a two-year follow-up, Olerud-Molander Ankle Scores (OMAS) were comparable between the cast group (89) and the surgery group (87).
Surgical intervention was associated with a higher rate of secondary procedures, primarily for hardware removal, and a greater risk of wound-related infections.
The findings suggest that mechanical stability achieved via casting is sufficient for fractures with an initially congruent mortise, potentially shifting the standard of care away from routine surgery.

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This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

Cast immobilization demonstrated non-inferiority to open reduction and internal fixation (ORIF) for Weber B fractures that are stable on static radiographs but unstable under stress testing.
At a two-year follow-up, Olerud-Molander Ankle Scores (OMAS) were comparable between the cast group (89) and the surgery group (87).
Surgical intervention was associated with a higher rate of secondary procedures, primarily for hardware removal, and a greater risk of wound-related infections.
The findings suggest that mechanical stability achieved via casting is sufficient for fractures with an initially congruent mortise, potentially shifting the standard of care away from routine surgery.