February 13, 2009
Plaster Is The Best Option For Sprains
British researchers have found that people with a sprained ankle recover faster if they are given a plaster cast, BBC News reported.
A 10-day below-knee cast is more effective than standard treatment with a tubular bandage, according to a study of 600 patients.
For years, the general medical opinion was that the best thing for a sprained ankle is to keep it moving.
In the UK, sprained ankles account for some 3-5 percent of all emergency room visits and they vary from minor stretching of the ligament to complete tears.
Doctors typically treat such sprains with ice, elevation, tubular compression bandage and advice to exercise.
However, tubular bandaging was consistently found to be the worst treatment, researchers said.
The researchers noted that in patients with severe ankle sprains, a 10-day below-knee cast was associated with a speedier recovery in terms of ankle function, pain, symptoms and activity after three months.
The Aircast brace, which limits movement of the ankle, was found to be the second best method of treatment.
The study also showed that the Bledsoe boot"”another type of brace designed to restrict movement of the ankle while allowing users to walk"”was no more effective than a tubular bandage. The study further recommended that neither treatment be used for ankle sprains.
A plaster cast is also one of the more modestly priced procedures for these types of injuries.
"The finding that immobilization is the best strategy is contrary to popular clinical opinion," said Professor Sallie Lamb, an expert in rehabilitation at the University of Warwick.
"Tubular compression bandage, which is currently the most commonly used of all the supports investigated, was, consistently, the worst treatment."
She said the speed with which people are able to get back to normal activities is an important finding.
"I think plaster should be given as standard management."
John Heyworth, president of the College of Emergency Medicine, called the study "practice-changing, high quality research".
Heyworth said, until this paper, the evidence suggested that early mobility provided a better outcome. "This provides some good evidence that immobilization can provide greater benefits."
Doctors have tried to avoid immobilizing the ankle because of the risk of deep vein thrombosis, according to Dr. Martin Shalley, A&E consultant at Birmingham Heartlands Hospital.
"That has to be balanced and we can discuss the pros and cons with the patient and work out the best treatment program for them."
On the Net: