Management of ankle sprains: a randomised controlled trial of the treatment of inversion injuries using an elastic support bandage or an Aircast ankle brace

Abstract

Background:Lateral ligament ankle sprains are the single most common sports injury.Objective:To determine the functional outcome of the ankle joint after a moderate or severe inversion injury, comparing standard treatment with an elastic support bandage against an Aircast ankle brace.Design:Prospective, randomised controlled trial.Setting:Two accident and emergency departments.Method:Fifty patients presenting consecutively were randomised into two equal groups: one group was treated with an elastic support bandage and the other with an Aircast ankle brace. All patients were given a standardised advice sheet referring to rest, ice, compression, and elevation. Patients were reviewed after 48–72 hours, 10 days, and one month.Primary outcome measure:Ankle joint function assessed at 10 days and one month using the modified Karlsson scoring method (maximum score 90).Secondary outcome measure:The difference in ankle girth (swelling) and pain score at 10 days.Results:Seventeen patients in the elastic support bandage group (six defaulted, two excluded) and 18 patients in the Aircast ankle brace group (six defaulted, one excluded) completed the study. There were no significant differences between the two groups at presentation in terms of age (mean 35.3 and 32.6 years respectively), sex, dominant leg, left or right ankle injured, previous injury, time to presentation (median three and four hours respectively), difference in ankle girth (mean 14.5 and 14.3 mm respectively), and pain scores (mean 6.2 and 5.8 respectively). The Karlsson score was significantly higher in the Aircast ankle cast group than in the elastic bandage group at 10 days (mean 50v35, p = 0.028, 95% confidence interval (CI) 1.7 to 27.7) and one month (mean 68v55, p = 0.029, 95% CI 1.4 to 24.8) (Student’sttest). There was no difference between the groups in the secondary outcome measures (swelling, p = 0.09; pain, p = 0.07). When hierarchical multiple regression analysis was used to correct for possible baseline confounding factors, the Aircast ankle brace group was significantly associated with higher Karlsson scores at 10 days (p = 0.009) and one month (p = 0.024).Conclusion:The use of an Aircast ankle brace for the treatment of lateral ligament ankle sprains produces a significant improvement in ankle joint function at both 10 days and one month compared with standard management with an elastic support bandage.

The Incidence and Prevalence of Ankle Sprain Injury: A Systematic Review and Meta-Analysis of Prospective Epidemiological Studies

“…There is also an abundance of literature investigating injury epidemiology in field based sports (98 of the studies included in our analysis were field-based focused). The high risk of ankle sprain has promoted an appropriate research response, as a large number of methodologically rigorous randomised control trials now exist investigating the effect of different interventions in injury rehabilitation (54,(228)(229)(230)(231) and prevention (232)(233)(234).…”

Ankle Injuries in Sports: Anatomical Considerations and Clinical Implications

“…Immobilization may result in joint stiffness, loss of propioception and late return to sports (Nuhmani & Khan 2013). Aircast ankle brace appear to be more effective to restore ankle joint function compared to elastic bandage support bandage (Boyce et al 2005).…”

Comparative study on management of acute moderate and severe lateral ankle sprain using immobilization in below knee slab versus stirrup ankle brace

“…1 The authors have reasoned that the method of assessing ankle girth by manual measurement of the circumference of the joint with a tape measure is open to practical error. More than one investigator measuring the girth introduces the potential for further error.…”

“…Ankle sprains produce 25% of all time loss due to injury in football, basketball, and crosscountry. 1 It constitutes approximately one quarter of all musculoskeletal injuries. 2 In Nepal, however there is no data available pertaining to incidence of ankle injuries and sprains.…”