title: Compression stockings in the management of fractures of the ankle: a randomised controlled trial.
abstract: In this randomised controlled trial, we evaluated the role of elastic compression using ankle injury stockings (AIS) in the management of fractures of the ankle. A total of 90 patients with a mean age of 47 years (16 to 79) were treated within 72 hours of presentation with a fracture of the ankle, 31 of whom were treated operatively and 59 conservatively, were randomised to be treated either with compression by AIS plus an Aircast boot or Tubigrip plus an Aircast boot. Male to female ratio was 36:54. The primary outcome measure was the functional Olerud-Molander ankle score (OMAS). The secondary outcome measures were; the American Orthopaedic Foot and Ankle Society score (AOFAS); the Short Form (SF)-12v2 Quality of Life score; and the frequency of deep vein thrombosis (DVT). Compression using AIS reduced swelling of the ankle at all time points and improved the mean OMAS score at six months to 98 (95% confidence interval (CI) 96 to 99) compared with a mean of 67 (95% CI 62 to 73) for the Tubigrip group (p < 0.001). The mean AOFAS and SF-12v2 scores at six months were also significantly improved by compression. Of 86 patients with duplex imaging at four weeks, five (12%) of 43 in the AIS group and ten (23%) of 43 in the Tubigrip group developed a DVT (p = 0.26). Compression improved functional outcome and quality of life following fracture of the ankle. DVTs were frequent, but a larger study would be needed to confirm that compression with AISs reduces the incidence of DVT.
authors.affiliation: University Hospital of South Manchester, Wythenshawe M23 9LT, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Sultan
authors.affiliation: University Hospital of South Manchester, Wythenshawe M23 9LT, UK.
authors.forename: T
authors.initials: T
authors.lastname: Zhing
authors.affiliation: University Hospital of South Manchester, Wythenshawe M23 9LT, UK.
authors.forename: J
authors.initials: J
authors.lastname: Morris
authors.affiliation: University Hospital of South Manchester, Wythenshawe M23 9LT, UK.
authors.forename: N
authors.initials: N
authors.lastname: Kurdy
authors.affiliation: University Hospital of South Manchester, Wythenshawe M23 9LT, UK.
authors.forename: C N
authors.initials: CN
authors.lastname: McCollum
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy*; D005260:Female; D050723:Fractures, Bone / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control / Q000534:rehabilitation; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D016037:Single-Blind Method; D053828:Stockings, Compression; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000517:prevention & control; D055815:Young Adult
keywords: Ankle fracture; Deep vein thrombosis; Elastic stockings; Functional outcome; Randomised clinical trial