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Immobilisation for acute ankle sprain. A systematic review.
G M Kerkhoffs1, B H Rowe, W J Assendelft
1University of Amsterdam, Academic Medical Center, Department of Orthopaedic Surgery, The Netherlands. ginokerkhoffs@hotmail.com
Archives of Orthopaedic and Trauma Surgery
|September 12, 2001
Summary
Functional treatment for acute ankle sprains leads to faster return to sports and work, with less swelling and better patient satisfaction compared to immobilisation. Immobilisation should be limited to specific cases and short durations.
Area of Science:
- Orthopedics
- Sports Medicine
- Physical Therapy
Background:
- Acute ankle sprains are common injuries with varied treatment approaches.
- A lack of evidence-based strategies necessitates a review of current practices.
Purpose of the Study:
- To evaluate the effectiveness of different immobilization methods for acute ankle sprains.
- To compare functional treatment versus immobilization for lateral ligament complex injuries.
Main Methods:
- Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
- Electronic database search including MEDLINE, EMBASE, and Cochrane Controlled Trial Register.
- Data extraction and statistical analysis (Relative Risk, Weighted Mean Difference) for outcomes like return to sports, work, swelling, and range of motion.
Main Results:
- Functional treatment showed statistically significant benefits over immobilization in six outcome measures.
- Faster return to sports (1.85 RR) and work (7.12 days WMD), reduced persistent swelling (1.44 RR), improved range of motion (1.64 RR), and higher patient satisfaction (6.50 RR).
- No outcomes favored immobilization.
Conclusions:
- Functional treatment appears more effective and should be encouraged for acute ankle sprains.
- Immobilization may be considered for specific patients and limited periods only.
- Evidence supports a shift towards functional rehabilitation strategies.