title: The use of early immobilization in the management of acute soft-tissue injuries of the knee: results of a survey of emergency physicians, sports medicine physicians and orthopedic surgeons.
abstract: BACKGROUND
  Evidence-based guidelines on the use of immobilization in the management of common acute soft-tissue knee injuries do not exist. Our objective was to explore the practice patterns of emergency physicians (EPs), sports medicine physicians (SMPs) and orthopedic surgeons (OS) regarding the use of early immobilization in the management of these injuries.
  
  
  METHODS
  We developed a web-based survey and sent it to all EPs, SMPs and OS in a Canadian urban centre. The survey was designed to assess the likelihood of prescribing immobilization and to evaluate factors associated with physicians from these 3 disciplines making this decision.
  
  
  RESULTS
  The overall response rate was 44 of 112 (39%): 17 of 58 (29%) EPs, 7 of 15 (47%) SMPs and 20 of 39 (51%) OS. In cases of suspected meniscus injuries, 9 (50%) EPs indicated they would prescribe immobilization, whereas no SMPs and 1 (5%) OS would immobilize (p = 0.002). For suspected anterior cruciate ligament injuries, 13 (77%) EPs, 2 (29%) SMPs and 5 (25%) OS said they would immobilize (p = 0.005). For lateral collateral ligament injuries, 9 (53%) EPs, no SMPs and 6 (32%) OS would immobilize (p = 0.04). All respondents would prescribe immobilization for a grossly unstable knee.
  
  
  CONCLUSIONS
  We found that EPs were are more likely to prescribe immobilization for certain acute soft-tissue knee injuries than SMPs and OS. The development of an evidenced- based guideline for the use of knee immobilization after acute soft-tissue injury may reduce practice variability.
authors.affiliation: The Department of Surgery, University of Alberta, Edmonton, Alta.
authors.forename: Mark
authors.initials: M
authors.lastname: Sommerfeldt
authors.affiliation: The Department of Surgery, University of Alberta, Edmonton, Alta.
authors.forename: Martin
authors.initials: M
authors.lastname: Bouliane
authors.affiliation: The Department of Surgery, University of Alberta, Edmonton, Alta.
authors.forename: David
authors.initials: D
authors.lastname: Otto
authors.affiliation: The Department of Emergency Medicine, University of Alberta, Edmonton, Alta.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Rowe
authors.affiliation: The Department of Physical Therapy, University of Alberta, Edmonton, Alta.
authors.forename: Lauren
authors.initials: L
authors.lastname: Beaupre
mesh_terms: D000416:Alberta; D003697:Delphi Technique; D004635:Emergency Medicine; D006801:Humans; D007103:Immobilization / Q000706:statistics & numerical data*; D007718:Knee Injuries / Q000175:diagnosis / Q000628:therapy*; D008487:Medical History Taking; D009985:Orthopedics; D010808:Physical Examination; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013178:Sports Medicine; D011795:Surveys and Questionnaires; D019037:Urban Health Services