Role of compression in management of ankle fractures

Role of compression in management of ankle fractures Sultan MJ 1, 3, 4, Zheng TT 1, 3, Hodhody G 1, Kurdy N 2, Mc. Collum CN 1, 3, 4 1 Academic Vascular Surgery Department, University Hospital of South Manchester (UHSM), 2 Department of Orthopaedic Surgery (UHSM), 3 Department of Vascular Surgery (UHSM), 4 University of Manchester, UK

Ankle fractures 60, 000/yr in UK NHS acute bed cost - £ 67 million/yr > 70% suffer long term symptoms

Ankle fracture randomise n=90 44 46

Study plan randomise x-ray physiotherapy <72 0 1 2 hrs 12 26 wks 4 8 OMAS AOFAS SF-12 v 2

ankle circumference index n=85 115 mean 95% CI % of 110 normal n=43 107 boot 105 p<0. 001 n=42 101 boot + ECS 100 95 90 0 4 8 weeks 12 26

DVT in 15 (18%) of 86 patients 43 boot alone patients 77% 43 boot + ECS patients 88% 23% 12% 10 DVT P=0. 26 5 DVT

Mean OMAS score n=85 score n=42 98 boot + ECS 100 n=43 67 boot 80 60 p<0. 001 40 20 0 4 12 8 weeks 26

Mean AOFAS score n=85 score n=42 105 boot + ECS 105 n=43 89 boot 80 p<0. 001 60 40 4 8 12 weeks 26

Mean SF 12 score n=85 score n=42 116 boot + ECS 120 110 n=43 99 boot 100 90 P<0. 001 80 70 4 8 12 weeks 26

In ankle fracture ECS improves functional outcome and Qo. L DVT is frequent (18%) ? Does ECS prevent DVT