***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Unilateral Colles ' fractures in 187 patients over the age of 55 years were studied in a r and omised prospect i ve trial : 97 fractures were minimally displaced and were treated either conventionally or in a crêpe b and age ; 90 displaced Colles ' fractures were reduced and of these 47 were treated conventionally while 43 were encouraged to mobilise the wrist in a cast which restricted extension . Early wrist movement hastened functional recovery and led to earlier resolution of wrist swelling . Discomfort was no greater than in patients who were treated conventionally . The bony deformity , which recurred irrespective of the method of treatment , was not adversely affected by early mobilisation The results of a prospect i ve controlled trial of early mobilisation of Colles ' fractures in the elderly are presented . Early mobilisation produced less pain and a stronger grip . It did not lead to any greater loss of reduction of the fracture . However , there was no significant improvement in the final range of movement of the wrist .  Immobilisation of the wrist for six weeks in plaster is extremely inconvenient for the elderly living alone and the patients greatly appreciated the reduction of this period of time to a minimum Twenty-four male New Zeal and rabbits underwent suture repair of a tenotomy of the left achilles tendon .  The rabbits were r and omized into two groups of 12 animals ; in group ( A ) , the ankle was immobilized by pinning for 35 days , while in the group ( B ) , the ankle was immobilized for only 14 days followed by active mobilization . Following sacrifice at 35 days postoperatively , the retrieved tendons were evaluated by biomechanical testing and histologic examination . Approximately 50 % of stretching occurred in the first four days ; average overall elongation was 9.5±1.0 mm and 12.7±1.5 mm ( p = 0.102 ) and average stiffness recovery was 67.4±2.0 % and 82.9±1.9 % ( p = 0.0004 ) for groups A and B respectively . Histologically both groups demonstrated traces of disorganized neo-collagen fibers at the repair site as early as the fourth day with subsequent appearance of more mature collagen . The results obtained from our study favor early mobilization of the repaired tendon , which seems to restore the functional properties of the tendons more rapidly than continuous immobilization of an identical surgical repair A question naire was sent out to 59 orthopaedic departments . Seventy-eight percent returned the question naire . Four thous and two hundred ankle fractures are treated annually . Fifty percent are operated on ( range 12.5 - 83 % ) . Large departments are on average more surgically active than smaller ones . The noticeable difference , however , in surgical frequency is not connected to size , function or location of orthopaedic department . All fractures are usually immobilized with a circular plaster b and age . Thirty percent use dynamic b and ages for some stable ankle fractures . Eighty-five percent b and age for six weeks , 15 % for up to eight weeks . Very few allow early mobilization of surgically treated fractures ( 6 % ) . The rest do not allow mobilization until at least three weeks after surgery . Stable fractures are more frequently permitted immediate mobilization . Several r and omized studies recommend that all ankle fractures should be mobilized immediately , surgically treated in a circular plaster b and age , stable fractures in dynamic b and ages In a prospect i ve , r and omized study , 30 patients were evaluated after ankle fracture treated by means of open reduction and internal fixation . The patients were r and omized to either postoperative immobilization in a plaster cast for 6 weeks or early mobilization ( 1–2 weeks after surgery ) in an ankle brace . Both regimens allowed weightbearing . Evaluation after 10 weeks and after 12 months included clinical assessment and isokinetic muscle strength measurements . Patients with impaired ankle function , as shown by means of an ankle score at 12 months , were followed for 3 years . At 10 weeks , impaired muscle torque and restricted range of motion was found on the affected side . This impairment was significantly less in the brace group . At 12 months , range of motion of the ankle and subtalar joints was restored , but dorsiflexion was still better in the brace group . Score values from a functional score did not correlate with muscle strength Two hundred consecutive patients with arthrographically verified rupture of one or both of the lateral ankle ligaments were allocated to treatment with either an operation and a walking cast , walking cast alone , or strapping with an inelastic tape - all for 5 weeks . Eighty-seven percent of the patients attended follow-up after 1 year . Only 5 percent in each treatment group were unsatisfied with the result . There were no differences between the treatment groups in ankle stability or symptoms during different activities , regardless of rupture of the anterior talofibular ligament alone or combined with rupture of the calcaneofibular ligament . However , the patients treated with tape had fewer symptoms , fewer complaints when running , and more ankles recovered to the preinjury state . Therefore , in lateral ankle ligament rupture , tape b and ages seem preferable Ninety consecutive women with unilateral Colles ' fractures were r and omized into two different treatment groups . The control group was treated for 5 weeks in conventional short-arm , below the elbow plaster of Paris casts . The other group ( N = 45 ) was treated similarly in plaster casts for 3 weeks and then had flexible casting applied for the remaining 2 weeks which allowed for early joint mobilization . Functional recovery was assessed by measuring grip strength and joint mobility at intervals over the 3 years . Radiographic and overall assessment s were also made during 3 year course of study . Virtually all patients reported greater comfort after switching to the flexible casting . Mean grip scores and joint mobilities were higher at all time points with early mobilization , reaching levels of statistical significance at 6 months for grip score and at 3 months for joint mobility . By 3 years most differences between treatment groups had resolved . We found no evidence that early mobilization was detrimental to recovery . We conclude that early mobilization is a satisfactory treatment option for Colles ' fracture , and may , in fact , hasten functional recovery Fifty-three patients with dislocated lateral malleolar fractures were r and omly selected after operation for either active ankle movement and weight bearing in an orthosis or no ankle movement but weight bearing in a walking cast . At follow-up examinations after three , six , and 18 months , no differences were found between the groups except for a better linear analogue scale result at three months for the orthosis group . Active ankle movements do not improve the rehabilitation of surgically treated lateral malleolar fractures A prospect i ve r and omised study was performed in order to compare plaster cast with Pliton-80 cast brace with a mobile plastic shoe insert in the treatment of ruptured fibular ankle ligaments . The two treatment groups consisted of 65 patients in each and all were participating in the follow-up sixth months after the accident . There were no statistically significant differences in the overall results between the two treatment groups . Because 1 ) the mobile Pliton-80 b and age subjectively is more acceptable to the patients and -2 ) the disability time in the Pliton-80 group was considerably shorter than in the plaster group -- it was concluded that the mobile Pliton-80 b and age can be recommended as the treatment of ruptures of the fibular ankle ligaments INTRODUCTION Pure posterior dislocation of the elbow is frequent in young subjects . The objective of treatment must be to reduce the dislocation and avoid complications , the most frequent being stiffness , but also elbow instability . The objective of this prospect i ve study was to evaluate the functional and anatomical characteristics of two treatment modalities : plaster immobilization and early mobilization . MATERIAL AND METHODS 50 cases of pure posterior dislocation of the elbow were included in a prospect i ve study and r and omized to two groups : Group I : twenty six cases were treated by  reduction under general anaesthesia and plaster immobilization for three weeks , followed by rehabilitation . Group II : twenty four cases were treated by reduction under general anaesthesia , followed by early mobilization . RESULTS We evaluated our results in terms of loss of amplitude of elbow movement ( particularly extension ) , stiffness , instability , relapses , pain and ossification . This study demonstrated better recovery of elbow function in patients treated by early mobilization : 96 % of good results with recovery of normal extension in group II versus 81 % of cases in group I. Stiffness was observed in 19 % of patients in group I versus 4 % in group II ; this difference was very significant . Comparison of pain revealed no significant difference and no relapses , instability or ossifications were observed in either of the two groups . DISCUSSION AND CONCLUSION Early mobilization is superior to plaster immobilization , as it allows recovery of better quality elbow function without inducing instability or recurrence We performed a prospect i ve r and omized study on 60 patients with dorsally displaced extra-articular or noncomminuted intraarticular fractures of the distal radius . All 60 fractures were treated by closed reduction and Kirchner wire trans-styloid fixation . 30 patients had 1 weeks ' postoperative immobilization and 30 patients had 6 weeks ' immobilization .  All patients had a clinical and radiographic review at 6 weeks and at 1 year after the operation . Pain , range of movement and grip strength were tested clinical ly , and changes in dorsal tilt , frontal radial deviation , ulnar variance , and radial shortening were assessed radiographically . Rates of complications were the same in both groups . At follow-up , pain was similar in both groups and range of motion and grip strength were somewhat better after early mobilization -- in comparison with the opposite wrist -- but this was statistically significant only for ulnar deviation . The postoperative radiographic reductions were similar in both groups , with no differences in loss of reduction after bone healing . Therefore , in Colles ' fractures , trans-styloid fixation with two K-wires seems to give a stable osteo synthesis , which does not need additional immobilization with a plaster cast A series of 68 undisplaced or minimally displaced Colles ' fractures was r and omized into two groups undergoing treatment with either a plaster cast or an elastic b and age .  Pain , function , grip strength , and range of motion were evaluated 1 year later . There was a difference in the functional outcome in favor of the patients treated with an elastic b and age , who did not have more fracture redislocations than those treated with a plaster cast BACKGROUND Different regimens of early motion of the ankle  after operative treatment of a ruptured Achilles tendon have been suggested since the late 1980s . However , as far as we know , no controlled studies comparing these regimens with conventional immobilization in a cast have been reported . METHODS In a prospect i ve study , seventy-one patients who had an acute rupture of the Achilles tendon were r and omized to either conventional postoperative management with a cast for eight weeks or early restricted motion of the ankle in a below-the-knee brace for six weeks . The brace was modified with an elastic b and on the posterior surface , in a manner similar to the principle of Kleinert traction . Metal markers were placed in the tendon , and the separation between them was measured on serial radiographs during the first twelve weeks postoperatively . The patients were assessed clinical ly when the cast or brace was removed , at twelve weeks postoperatively , and at a median of sixteen months postoperatively . RESULTS The separation between the markers at twelve weeks postoperatively was nearly identical in the two groups , with a median separation of 11.5 millimeters ( range , zero to thirty-three millimeters ) in the patients managed with early motion of the ankle and nine millimeters ( range , one to forty-one millimeters ) in the patients managed with a cast . The separation was primarily correlated with the initial tautness of the repair ( r[S ] = 0.45 ) . No patient had excessive lengthening of the tendon . The patients managed with early motion had a smaller initial loss in the range of motion , and they returned to work and sports activities sooner than those managed with a cast . Furthermore , there were fewer visible adhesions between the repaired tendon and the skin in the patients managed with early motion , and these patients were subjectively more satisfied with the overall result . The patients in both groups recovered a median of 89 percent of strength of plantar flexion compared with that of the noninjured limb , as measured with an isometric strain-gauge at 15 degrees of dorsiflexion . The heel-rise index was similar for both groups : 0.88 for the patients managed with early motion and 0.89 for those managed with a cast . CONCLUSIONS Early restricted motion appears to shorten the time needed for rehabilitation . There were no complications related to early motion in these patients . However , early unloaded exercises did not prevent muscle atrophy Abstract . The aim of this study was to compare the clinical outcome for patients treated with walking cast immobilization and wrap early mobilization after surgical repair of acute Achilles tendon ruptures . A total of 39 consecutive patients with complete ruptures of the Achilles tendon were identified , treated , and functionally rehabilitated with either a walking cast or a wrap . Because the r and omization was quasi-r and om , chi-square and t-tests were performed to compare the baseline characteristics . A statistically significant difference was present only for the injured side ( p<0.05 ) . Therefore , groups were considered comparable for analysis of outcome . All patients were evaluated at an average follow-up of 6.7 years ( range 5–8 years ) . Functional postoperative treatment with a wrap allowed a significantly shorter hospital stay ( p<0.05 ) as well as a shorter period to return to pre-injury sports level ( p<0.01 ) compared with treatment with a walking cast . According to the modified Rupp score , 91.3 % of patients in the walking cast group had a good or excellent result , as did 93.8 % in the wrap group ( p=0.9 ) . Slight atrophy of the calf muscles was reported in 3 patients in the walking 
    Output:
    
Reported benefits of mobilization included earlier return to work ; decreased pain , swelling , and stiffness ; and a greater preserved range of joint motion .
Early mobilization caused no increased complications , deformity or residual symptoms .
CONCLUSIONS We should not assume any benefit for immobilization after acute upper or lower limb injuries in adults .
Rest appears to be overused as a treatment .