Badly Sprained Ankles Deserve a Cast

If you've ever injured your ankle, you'll probably heave a sigh of relief when you hear that there isn't a fracture. This radiology result doesn't necessarily mean you'll avoid a couple of weeks in a cast, however. A recent study, published in the Lancet, has shown that bad sprains do better with a below-knee cast than just 'strapping' or a Bledsoe boot.

Warwick University, UK, researchers enrolled 580 patients with severe ankle injuries. The patients, from 8 emergency departments, were randomly assigned to treatment by a tubular compression bandage, a Bledsoe boot, a 10-week below-knee cast, or an Aircast. All treatments were begun within 3 days of the injury. The results were assessed at 3 months, with a follow up at 9 months.

Both the below-knee cast and the Aircast produced immobilization, and the best overall results at 3 months. The tubular bandage had the worst results, followed closely be the Bledsoe boot. Both of these allow considerable movement of the joint, and were clearly inferior to the cast and Aircast at 3 months. However, at 9 months there were no differences between the results of the different treatments. So maybe even if you didn't get the optimal treatment at first, by next year it will have made no difference.