Does PROM Always Reflect the Reality? Our Experience with the Olerud-Molander Ankle Score (OMAS) in the Ongoing Ankle Fracture p-RCT (DoWeCAST)

The use of Patient-Reported Outcome Measures (PROMs) has become more prevalent in recent years. PROMs provide a direct reflection of the patient`s health and function to the effect of treatment or intervention provided [1-3]. The Olerud-Molander Ankle Score (OMAS) is a commonly used PROM in ankle fracture research and often, it is the primary outcome measure [4-10]. This questionnaire was developed in 1984, specifically, to evaluate the function of patients with ankle fractures [11]. A recent systematic review evaluating patients reported outcome measures used for adults with ankle fracture, found that OMAS has sufficient levels of reliability, internal consistency and construct validity. However, the review did not recommend any particular PROM due to insufficient supporting evidence [12].

(DoWeCAST) trial is a pragmatic randomized controlled multi-center trial, comparing Immediate Weight-Bearing (IWB) in a walking boot versus Non-Weight Bearing (NWB) and immobilization in a cast, following ORIF of all types of unstable adult’s ankle fractures [13]. The trial which started in January 2019 is forecast to be the largest and the most comprehensive trial investigating the immediate post-operative weight-bearing of ankle fractures worldwide and is expected to complete enrollment by July 2020.