Primary Treatment of Acute Ankle Sprain: Retrospective Comparison of Cast Immobilization and Functional Ankle Brace

Su-Young Bae; Soo Hyung Ahn; Hyung-Jin Chung; Min-Cheol Kam

doi:10.14193/jkfas.2019.23.3.105

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Bae, Ahn, Chung, and Kam: Primary Treatment of Acute Ankle Sprain: Retrospective Comparison of Cast Immobilization and Functional Ankle Brace

Original Article

Journal of Korean Foot and Ankle Society 2019; 23(3): 105-109.

Published online: 17 September 2019

DOI: https://doi.org/10.14193/jkfas.2019.23.3.105

Primary Treatment of Acute Ankle Sprain: Retrospective Comparison of Cast Immobilization and Functional Ankle Brace

Su-Young Bae

, Soo Hyung Ahn, Hyung-Jin Chung, Min-Cheol Kam^*

Department of Orthopedic Surgery, Inje University Sangye Paik Hospital, Seoul, Korea.

^*Department of Orthopedic Surgery, Changwon Himchan Hospital, Changwon, Korea.

Corresponding Author: Su-Young Bae. Department of Orthopedic Surgery, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 01757, Korea. Tel: 82-2-950-1399, Fax: 82-2-950-1398, sybae99@gmail.com

Received 30 July 2019 Revised 28 August 2019 Accepted 28 August 2019

Korean Foot and Ankle Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain.

Materials and Methods

This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared.

Results

The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization.

Conclusion

Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.

Keywords: Ankle, Acute sprain, Cast immobilization, Functional treatment

Figures and Tables

Figure 1

Treatment algorithm.

Figure 2

Percentage of remnant symptom at 3 weeks after initial visit.

Figure 3

Percentage of remnant symptom at last visit.

Table 1

Geographics of the Patients

Values are presented as number or mean±standard deviation.

Table 2

Clinical Result of Each Treatment Group at 3 Weeks after Initial Visit

Values are presented as number (%).

Table 3

Clinical Result of Each Treatment Group at Final Visit

Values are presented as number (%).

Notes

^{Financial support} This work was supported by the 2011 Inje University research grant.

^{Conflict of interest} None.

References

1. Freeman MA. Treatment of ruptures of the lateral ligament of the ankle. J Bone Joint Surg Br. 1965; 47:661–668.

2. Kannus P, Renström P. Treatment for acute tears of the lateral ligaments of the ankle. Operation, cast, or early controlled mobilization. J Bone Joint Surg Am. 1991; 73:305–312.

3. Clark BL, Derby AC, Power GR. Injuries of the lateral ligament of the ankle. Conservative vs. operative repair. Can J Surg. 1965; 8:358–363.

4. Evans GA, Hardcastle P, Frenyo AD. Acute rupture of the lateral ligament of the ankle. To suture or not to suture? J Bone Joint Surg Br. 1984; 66:209–212.

5. Hertel J. Functional instability following lateral ankle sprain. Sports Med. 2000; 29:361–371. DOI: 10.2165/00007256-200029050-00005.

6. Gribble PA, Bleakley CM, Caulfield BM, Docherty CL, Fourchet F, Fong DT, et al. Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med. 2016; 50:1496–1505. DOI: 10.1136/bjsports-2016-096189.

7. Kim DW, Sung KS. Chronic lateral ankle instability. J Korean Foot Ankle Soc. 2018; 22:55–61. DOI: 10.14193/jkfas.2018.22.2.55.

8. Kitaoka HB, Lee MD, Morrey BF, Cass JR. Acute repair and delayed reconstruction for lateral ankle instability: twenty-year follow-up study. J Orthop Trauma. 1997; 11:530–535.

9. Prins JG. Diagnosis and treatment of injury to the lateral ligament of the ankle. a comparative clinical study. Acta Chir Scand Suppl. 1978; 486:3–149.

10. Kerkhoffs GM, Rowe BH, Assendelft WJ, Kelly K, Struijs PA, van Dijk CN. Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults. Cochrane Database Syst Rev. 2002; (3):CD003762. DOI: 10.1002/14651858.CD003762.

11. Lamb SE, Marsh JL, Hutton JL, Nakash R, Cooke MW. Collaborative Ankle Support Trial (CAST Group). Mechanical supports for acute, severe ankle sprain: a pragmatic, multicentre, randomised controlled trial. Lancet. 2009; 373:575–581. DOI: 10.1016/S0140-6736(09)60206-3.

12. Cass JR, Morrey BF. Ankle instability: current concepts, diagnosis, and treatment. Mayo Clin Proc. 1984; 59:165–170. DOI: 10.1016/s0025-6196(12)60769-1.

13. Campbell DG, Menz A, Isaacs J. Dynamic ankle ultrasonography. a new imaging technique for acute ankle ligament injuries. Am J Sports Med. 1994; 22:855–858. DOI: 10.1177/036354659402200620.

14. Oae K, Takao M, Uchio Y, Ochi M. Evaluation of anterior talofibular ligament injury with stress radiography, ultrasonography and MR imaging. Skeletal Radiol. 2010; 39:41–47. DOI: 10.1007/s00256-009-0767-x.

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ORCID iDs: Su-Young Bae
https://orcid.org/0000-0002-2954-2511
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