Comparison of two main treatment modalities for acute ankle sprain

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SCIENCE
Comparison of two main treatment modalities for acute ankle sprain
Key Take-Away: 

An elastic bandage for functional treatment of acute ankle sprains better preserves joint motion and reduces the extent of edema size than a splint, after 7 days of treatment. However, there was no significant difference in pain scores between the groups.

Acute ankle injuries are one of the most common musculoskeletal injuries in emergency department. The main predisposing factor to an ankle sprain is a previous ankle sprain. Ankle injuries account for 3–5% and 2–6% of overall visits to emergency departments in Britain and United States.

ABSTRACT: 
Background: 

Acute ankle injuries are one of the most common musculoskeletal injuries in emergency department. The main predisposing factor to an ankle sprain is a previous ankle sprain. Ankle injuries account for 3–5% and 2–6% of overall visits to emergency departments in Britain and United States.

Although ankle immobilization is the basic treatment modality functional treatment methods that preserve range of motion of joints have been presented recently. In addition to the lack of evidence-based studies that compare treatment methods, no studies have definitely concluded optimal functional treatment strategy for such injuries.

  • Rationale behind research
  1. No study has given a definitive conclusion about the optimal functional treatment strategy for ankle injuries.
  2. Therefore, the present study was conducted to compare the effectiveness of two treatment modalities for the management of acute ankle sprain specifically in terms of edema reduction and pain relief.
  • Objective: To compare two treatment modalities: splint and elastic bandage for the management of acute ankle sprains.
Methods: 

 

 

  • Study outcomes

Extend of edema was evaluated using a small graduated cylinder filled with warm water.

Pain score was measured using visual analog scale (VAS)

Time points: Baseline and after 7 days of treatment

Results: 

 

 

Outcomes:

  • Pain scores decreased significantly in both groups after 7 days of treatment however, the differences between their VAS scores were not significant.

Fig 1: Pain scores of the groups

  • Both techniques reduced the extension of edema but reduction was more significant in elastic bandage group than in the splint group (p=0.025).

Fig 2: Edema evaluations of the groups

Conclusion: 

The current consensus in the treatment of acute ankle sprains for adults indicates that functional treatment options such as taping or elastic bandage is superior to rigid treatment such as external ankle supports. However, there are insufficient results of studies that have compared external support and pure functional treatment. Moreover, current comparisons of treatment choices for ankle sprain have shown inconsistent results.

In the literature, functional treatment methods and immobilization have been compared in the context of pain, range of motion, patient satisfaction, complications and swelling. However, the extent to which edema reduces with treatment has not been clearly studied. Unlike that in previous studies, in the current study, the extent to which edema reduced was evaluated by measuring the volume of water displaced by the injured foot compared to that displaced by the uninjured foot. The edema size reduced to a significantly greater extent in the elastic bandage group than in the splint group.

Pak J Med Sci. 2015 Nov-Dec; 31(6): 1496–1499.

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