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Clinical and cost effectiveness of mechanical support for severe ankle sprains : design of a randomised controlled trial in the emergency department [ISRCTN 37807450]\ud

By S. E. Lamb, Rachel Anne Nakash, Emma J. Withers, M. D. Clark, J. L. Marsh, Sue Wilson, Jane Hutton, Ala Szczepura, Jeremy Dale and Matthew Cooke

Abstract

Background\ud The optimal management for severe sprains (Grades II and III) of the lateral ligament complex of the ankle is unclear. The aims of this randomised controlled trial are to estimate (1) the clinical effectiveness of three methods of providing mechanical support to the ankle (below knee cast, Aircast® brace and Bledsoe® boot) in comparison to Tubigrip®, and (2) to compare the cost of each strategy, including subsequent health care costs.\ud \ud Methods/design\ud Six hundred and fifty people with a diagnosis of severe sprain are being identified through emergency departments. The study has been designed to complement routine practice in the emergency setting. Outcomes are recovery of mobility (primary outcome) and usual activity, residual symptoms and need for further medical, rehabilitation or surgical treatment. Parallel economic and qualitative studies are being conducted to aid interpretation of the results and to evaluate the cost-effectiveness of the interventions.\ud \ud Discussion\ud This paper highlights the design, methods and operational aspects of a clinical trial of acute injury management in the emergency department.\ud \u

Topics: RC
Publisher: BioMed Central Ltd.
Year: 2005
OAI identifier: oai:wrap.warwick.ac.uk:576

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Citations

  1. (2003). A survey of current consultant practice of treatment of severe ankle sprains in emergency departments in the United Kingdom. Emerg Med J doi
  2. (2002). Clinical Systems Improvement (ICSI).: Health care guideline - ankle sprain.
  3. (2002). DB: Statistical analysis with missing data. 2nd edition. doi
  4. (2000). de Velde CJH: Self-reports of health care utilization: can a questionnaire replace a diary?. doi
  5. (1993). Decision rules for the use of radiography in acute ankle injuries. Refinement and prospective validation. JAMA
  6. (1998). Double bandaging of sprained ankles. doi
  7. (1986). Early mobilizing treatment in lateral ankle sprains. Course and risk factors for chronic painful or function-limiting ankle.
  8. (1997). FH: The role of proprioception in the management and rehabilitation of athletic injuries. doi
  9. (1997). GW: Methods for the economic evaluation of health care programmes. Second edition. doi
  10. (1995). Injuries to the pelvis and lower limb. In Science and medicine in sport 2nd edition. Edited by:
  11. (1989). Inversion trauma of the ankle. Arch Orthop Trauma Surg doi
  12. Measuring disability in a longitudinal survey.
  13. (2003). MW: Conducting clinical trials in accident and emergency medicine - a pilot study highlights recruitment challenges. In
  14. (1997). Obstacles to research in A&E. doi
  15. (1999). Paice C: Assessment of the SF-36 version 2 in the United Kingdom. doi
  16. (1991). Peterson L: Evaluation of ankle joint function: the use of a scoring scale. The Foot doi
  17. (1997). Physiotherapy: The contribution. In Cambridge textbook of accident and emergency medicine Edited by: Skinner
  18. (1988). Reinherz RP: Identification of epiphyseal ankle injuries.
  19. (2000). RK: Treatment of ruptures of the lateral ankle ligaments: a meta-analysis. J Bone Joint Surg Am
  20. (1998). Sayli U: Comparison of the results of short-term rigid and semi-rigid cast immobilization for the treatment of grade 3 inversion injuries of the ankle. Injury doi
  21. (2004). SE: Multi-item outcome measures for lateral ligament injury of the ankle: a structured review. J Eval Clin Pract doi
  22. (1976). The sickness impact profile: conceptual formulation and methodology for the development of a health status measure. doi
  23. (1996). Unit costs of health and social care.

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