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Casting Seems Best for Severe Ankle Sprains
Date:2/12/2009

Results are better with brief immobilization than with bandage or boot, study finds,,

THURSDAY, Feb. 12 (HealthDay News) -- People with severe ankle sprains recover faster with a short period of immobilization in a below-the-knee cast or an Aircast brace than with the use of either a tubular compression bandage or a Bledsoe boot, according to a U.K. study.

Along with receiving one of the four types of joint support, 584 people with severe ankle sprains were given advice on reducing swelling and pain. After three months, those who wore a cast for 10 days showed 9 percent more ankle function improvement than people who had been treated with the bandage, along with more improvement in pain, symptoms and activity.

People who had worn the Aircast brace showed 8 percent more improvement than the bandage group, but there was little difference in pain, symptoms and activity. The Bledsoe boot offered no advantage over the bandage, the study found.

The findings were published in this week's issue of The Lancet.

The most commonly used treatments for severe ankle sprain are ice, elevation, tubular compression bandages and advice to exercise. Complete immobilization is discouraged, according to the study authors, who said their findings challenge that approach.

"Contrary to popular clinical opinion, a period of immobilization was the most effective strategy for promoting rapid recovery," Professor Sarah Lamb, of the University of Warwick, and her colleagues said in a journal news release. "This was achieved by the application of a below-knee cast. The Aircast brace was a suitable alternative to below-knee casts. Results for the Bledsoe boot were disappointing, especially in view of the substantial additional cost of this device. Tubular compression, which is currently the most commonly used of all the supports investigated, was, consistently, the worst treatment."

The authors recommended
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