Abstract
Introduction
Long-term ankle pain, stiffness or swelling are frequent following ankle fracture. We investigated whether engineered compression stocking (ECS) influenced functional outcome and quality of life (QoL).
Methods
Ninety patients < 72 hours following ankle fracture, (59 conservative and 31 operative fixation) were randomised to i) ECS + air-cast boot or ii) air-cast boot alone. Patients were followed at 2, 4, 8, 12 weeks and 6 months for Olerud Molander Ankle Score (OMAS), American Orthopaedic Foot and Ankle Score (AOFAS) and SF12v2 score with duplex imaging for deep vein thrombosis (DVT) at 4 weeks. 22 controls managed by plaster of paris (POP) were also assessed at 6 months only.
Results
Of 90 patients recruited, 29 (14 ECS + boot and 15 boot alone) have completed 6 month follow up. The mean (95%CI) foot, ankle and calf circumferences of the injured leg as a percentage of the normal leg were 100%, 100% and 99% at 6 months for ECS + boot compared with 106%, 109% and 102% for boot alone (p<0.001) and 103%, 106% and 102% for POP. By 6 months, the mean OMAS score for ECS + boot was 94, significantly better than 65 for boot alone and 59 for POP (p<0.001). AOFAS scores were also significantly improved at 105 with ECS compared to 87 for boot alone and 78 for POP (p<0.001). Mean SF12v2 scores were 115 for ECS + boot and 99 for boot alone and 91 for POP (p = 0.001).
Of the 78 patients completing duplex imaging at 4 week, 5 (13%) of 38 ECS + boot patients had a DVT compared with 10 (25%) of the 40 boot alone patients (p = 0.30).
Conclusion
ECS improve functional outcome and quality of life following ankle fractures.
