A recent study in The Lancet shows that treatment of severe ankle sprains with a below the knee cast is more effective than a compression bandage. A total of 584 participants with severe ankle sprains from eight emergency departments were included in a study to evaluate different treatment methods. Patients were placed in a below-knee cast, an Aircast brace, a Bledsoe boot (walking boot) or a tubular compression bandage. Patients were evaluated at three months and nine months.
Those who received a below-knee cast had significant improvement in pain, symptoms and the quality of ankle function compared with the tubular compression bandage. Those placed in an Aircast brace experienced an improvement in the quality of ankle function, but had no difference in pain or symptoms in comparison to the compression bandage. Those placed in the Bledsoe boot had no benefit over the tubular compression bandage at three months. When the patients were evaluated again at nine months, there were no significant differences between the tubular compression bandage and other treatments (1).
DR'S RESPONSE: This might seem obvious, but any kind of conservative treatment that limits or prohibits motion in an area of injury would be the best treatment option. The important point to decipher is that regardless of treatment, at 9 month follow-up, there were no significant statistical differences noted. Thus, one must measure cost with effectiveness when treating injuries.
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