title: A prospective, randomized clinical investigation of the treatment of first-time ankle sprains.
abstract: BACKGROUND
  Acute ankle ligament sprains are treated with the use of controlled mobilization with protection provided by external support (eg, functional treatment); however, there is little information regarding the best type of external support to use.
  
  
  OBJECTIVE
  There is no difference between elastic wrapping, bracing, bracing combined with elastic wrapping, and casting for treatment of acute, first-time ankle ligament sprains in terms of the time a patient requires to return to normal function.
  
  
  METHODS
  Randomized controlled clinical trial; Level of evidence, 1.
  
  
  METHODS
  Patients suffering their first ligament injury were stratified by the severity of the sprain (grades I, II, or III) and then randomized to undergo functional treatment with different types of external supports. The patients completed daily logs until they returned to normal function and were followed up at 6 months.
  
  
  RESULTS
  Treatment of grade I sprains with the Air-Stirrup brace combined with an elastic wrap returned subjects to normal walking and stair climbing in half the time required for those treated with the Air-Stirrup brace alone and in half the time required for those treated with an elastic wrap alone. Treatment of grade II sprains with the Air-Stirrup brace combined with the elastic wrap allowed patients to return to normal walking and stair climbing in the shortest time interval. Treatment of grade III sprains with the Air-Stirrup brace or a walking cast for 10 days followed by bracing returned subjects to normal walking and stair climbing in the same time intervals. The 6-month follow-up of each sprain severity group revealed no difference between the treatments for frequency of reinjury, ankle motion, and function.
  
  
  CONCLUSIONS
  Treatment of first-time grade I and II ankle ligament sprains with the Air-Stirrup brace combined with an elastic wrap provides earlier return to preinjury function compared to use of the Air-Stirrup brace alone, an elastic wrap alone, or a walking cast for 10 days.
authors.affiliation: Department of Orthopaedics & Rehabilitation, McClure Musculoskeletal Research Center, University of Vermont, Burlington, VT 05405-0084, USA. bruce.beynnon@uvm.edu
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Beynnon
authors.forename: Per A
authors.initials: PA
authors.lastname: Renström
authors.forename: Larry
authors.initials: L
authors.lastname: Haugh
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Uh
authors.forename: Howard
authors.initials: H
authors.lastname: Barker
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000145:classification / Q000534:rehabilitation*; D001458:Bandages; D001915:Braces; D002370:Casts, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017844:Lateral Ligament, Ankle / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D012720:Severity of Illness Index; D013180:Sprains and Strains / Q000145:classification / Q000534:rehabilitation*; D016896:Treatment Outcome