Plaster Casts Speed Sprain Recovery

    Contradicting long-standing traditional notions that sprained ankles can best be healed through tubular bandages and “walking it off,” a recent study showed that full-immobilization plaster casts work far better in recovery from sprains.          The research, done in Britain on 600 patients and published in the journal The Lancet, found that treatment of sprains with a 10-day below-knee cast was superior to the standard tubular bandage remedy. About 23,000 people a day are treated for ankle sprains in U.S. emergency rooms. In Britain, the injury accounts for 3 percent to 5 percent of all emergency room cases.

In the study on patients with severely sprained ankles, plaster casts were found to promote faster recovery in the areas of ankle function, pain relief, symptom alleviation and activity three months later. The second-best treatment was an Aircast brace, a device that restricts the ankle’s movement.

The research team found that a tubular bandage was without fail the worst treatment. Another dud was the Bledsoe boot – a type of brace that limits movement of the ankle but still allows users to walk. It was no better than a tubular bandage, the scientists said.
    
By nine months, there was no difference between the differently treated groups. But there’s a considerable difference in cost between the treatments, the scientists noted. A plaster cast costs about $23, they said, compared with about $55 for an Aircast brace, $304 for the Bledsoe boot and only $2 for a tubular compression bandage.
     
Sallie Lamb, a rehabilitation expert and a professor at the University of Warwick, said the discovery that the plaster cast is the best approach is “contrary to popular clinical opinion.” But, she said, because casts promote faster recovery, at the three-month mark, patients would be greatly benefited.

Therefore, she concluded, “I think plaster should be given as standard management.” John Heyworth, president of Britain’s College of Emergency Medicine, said the study was “practice-changing, high-quality research.” “What we do with these common problems, is we look for the best evidence and, up until this paper, the evidence suggested that early mobility provided a better outcome, and this provides some good evidence that immobilization can provide greater benefits.”


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