DOI QR코드

DOI QR Code

족관절 급성 염좌의 일차 치료: 석고고정과 기능적 보조기를 이용한 치료의 후향적 비교

Primary Treatment of Acute Ankle Sprain: Retrospective Comparison of Cast Immobilization and Functional Ankle Brace

  • 배서영 (인제대학교 상계백병원 정형외과) ;
  • 안수형 (인제대학교 상계백병원 정형외과) ;
  • 정형진 (인제대학교 상계백병원 정형외과) ;
  • 감민철 (창원힘찬병원 정형외과)
  • Bae, Su-Young (Department of Orthopedic Surgery, Inje University Sangye Paik Hospital) ;
  • Ahn, Soo Hyung (Department of Orthopedic Surgery, Inje University Sangye Paik Hospital) ;
  • Chung, Hyung-Jin (Department of Orthopedic Surgery, Inje University Sangye Paik Hospital) ;
  • Kam, Min-Cheol (Department of Orthopedic Surgery, Changwon Himchan Hospital)
  • 투고 : 2019.07.30
  • 심사 : 2019.08.28
  • 발행 : 2019.09.15

초록

Purpose: To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain. Materials and Methods: This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared. Results: The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization. Conclusion: Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.

키워드

참고문헌

  1. Freeman MA. Treatment of ruptures of the lateral ligament of the ankle. J Bone Joint Surg Br. 1965;47:661-8. https://doi.org/10.1302/0301-620X.47B4.661
  2. Kannus P, Renstrom P. Treatment for acute tears of the lateral ligaments of the ankle. Operation, cast, or early controlled mobilization. J Bone Joint Surg Am. 1991;73:305-12. https://doi.org/10.2106/00004623-199173020-00021
  3. Clark BL, Derby AC, Power GR. Injuries of the lateral ligament of the ankle. Conservative vs. operative repair. Can J Surg. 1965;8:358-63.
  4. Evans GA, Hardcastle P, Frenyo AD. Acute rupture of the lateral ligament of the ankle. To suture or not to suture? J Bone Joint Surg Br. 1984;66:209-12. https://doi.org/10.2106/00004623-198466020-00007
  5. Hertel J. Functional instability following lateral ankle sprain. Sports Med. 2000;29:361-71. doi: 10.2165/00007256-200029050-00005.
  6. Gribble PA, Bleakley CM, Caulfield BM, Docherty CL, Fourchet F, Fong DT, et al. Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med. 2016;50:1496-505. doi: 10.1136/bjsports-2016-096189.
  7. Kim DW, Sung KS. Chronic lateral ankle instability. J Korean Foot Ankle Soc. 2018;22:55-61. doi: 10.14193/jkfas.2018.22.2.55.
  8. Kitaoka HB, Lee MD, Morrey BF, Cass JR. Acute repair and delayed reconstruction for lateral ankle instability: twenty-year follow-up study. J Orthop Trauma. 1997;11:530-5. https://doi.org/10.1097/00005131-199710000-00012
  9. Prins JG. Diagnosis and treatment of injury to the lateral ligament of the ankle. a comparative clinical study. Acta Chir Scand Suppl. 1978;486:3-149.
  10. Kerkhoffs GM, Rowe BH, Assendelft WJ, Kelly K, Struijs PA, van Dijk CN. Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults. Cochrane Database Syst Rev. 2002;(3):CD003762. doi: 10.1002/14651858.CD003762.
  11. Lamb SE, Marsh JL, Hutton JL, Nakash R, Cooke MW; Collaborative Ankle Support Trial (CAST Group). Mechanical supports for acute, severe ankle sprain: a pragmatic, multicentre, randomised controlled trial. Lancet. 2009;373:575-81. doi: 10.1016/S0140-6736(09)60206-3.
  12. Cass JR, Morrey BF. Ankle instability: current concepts, diagnosis, and treatment. Mayo Clin Proc. 1984;59:165-70. doi: 10.1016/s0025-6196(12)60769-1.
  13. Campbell DG, Menz A, Isaacs J. Dynamic ankle ultrasonography. a new imaging technique for acute ankle ligament injuries. Am J Sports Med. 1994;22:855-8. doi: 10.1177/036354659402200620.
  14. Oae K, Takao M, Uchio Y, Ochi M. Evaluation of anterior talofibular ligament injury with stress radiography, ultrasonography and MR imaging. Skeletal Radiol. 2010;39:41-7. doi: 10.1007/s00256-009-0767-x.