Abstract
Background
Ankle sprains are very common injuries which can lead to long-term pain, swelling and instability. Compression is often used in the treatment of these common injuries but is it effective and how best is it delivered?
Methods
MEDLINE (1966-current), EMBASE (1980-current), Cochrane Library (2011:1) and MEDION were included in our search. Studies evaluating compression in the treatment of ankle sprains were included. Two authors independently reviewed potential studies according to a set eligibility criteria.
Results
Twelve studies including 1,701 patients with ankle sprains were identified (level of evidence: four grade 1b; five grade 2b; three grade 4). Intermittent pneumatic compression (IPC), elastic tubular bandage and compression bandaging were all evaluated. Five of the 12 studies reported that compression therapy improves recovery after ankle injury, of which one evaluated IPC, and the remaining four elastic bandages (Elastoplast, class II elastic stockings, wool and crepe, focal compression with air stirrup). Five studies evaluating Tubigrip in ankle sprains concluded that Tubigrip has no positive effect on functional recovery and may increase the requirement for analgesia compared with no intervention.
Conclusion
Compression may be an effective tool in the management of ankle injuries and has been shown to reduce swelling and improve quality of life in single studies. Definitive conclusions are hampered by the poor quality of evidence and the variety of treatments used. The most effective form of compression to treat ankle sprains or is yet to be determined. Adequately designed randomized control trials are clearly needed.


Similar content being viewed by others
References
Nicholl JP, Coleman P, Williams BT (1991) Pilot study of the epidemiology of sports injuries and exercise-related morbidity. Br J Sports Med 25(1):61–66
Pijnenburg AC, Van Dijk CN, Bossuyt PM, Marti RK (2000) Treatment of ruptures of the lateral ankle ligaments: a meta-analysis. J Bone Joint Surg 82(6):761–773
Garrick JG (1977) The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med 5(6):241–242
Gerber JP, Williams GN, Scoville CR, Arciero RA, Taylor DC (1998) Persistent disability associated with ankle sprains: a prospective examination of an athletic population. Foot Ankle Int 19(10):653–660
Verhagen RA, de Keizer G, van Dijk CN (1995) Long-term follow-up of inversion trauma of the ankle. Arch Orthop Trauma Surg 114(2):92–96
Anandacoomarasamy A, Barnsley L (2005) Long term outcomes of inversion ankle injuries. Br J Sports Med 39(3):e14 discussion e14
O’connor G, Martin AJ (2011) Acute ankle sprain: is there a best support? Eur J Emerg Med 18(4):225–230
Konradsen L, Bech L, Ehrenbjerg M, Nickelsen T (2002) Seven years follow-up after ankle inversion trauma. Scand J Med Sci Sports 12(3):129–135
Wilson S, Cooke M (1998) Double bandaging of sprained ankles. Br Med J 317(7174):1722–1723
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700
Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD et al (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. Br Med J 343:d5928
Boyce SH, Quigley MA, Campbell S (2005) Management of ankle sprains: a randomised controlled trial of the treatment of inversion injuries using an elastic support bandage or an Aircast ankle brace. Br J Sports Med 39(2):91–96
Lamb SE, Marsh JL, Hutton JL, Nakash R, Cooke MW, Collaborative Ankle Support Trial (CAST Group) (2009) Mechanical supports for acute, severe ankle sprain: a pragmatic, multicentre, randomised controlled trial. Lancet 373(9663):575–581
Sultan MJ, McKeown A, McLaughlin I, Kurdy N, McCollum CN (2012) Elastic stockings or Tubigrip for ankle sprain: a randomised clinical trial. Injury 43(7):1079–1083
Sultan MJ, Zhing T, Morris J, Kurdy N, McCollum CN (2014) Compression stockings in the management of fractures of the ankle: a randomised controlled trial. Bone Joint J 96-B(8):1062–1069
Airaksinen O, Kolari PJ, Miettinen H (1990) Elastic bandages and intermittent pneumatic compression for treatment of acute ankle sprains. Arch Phys Med Rehabil 71(6):380–383
Dettori JR, Pearson BD, Basmania CJ, Lednar WM (1994) Early Ankle Mobilization. 1. The Immediate Effect on Acute, Lateral Ankle Sprains (a Randomized Clinical-Trial). Mil Med 159(1):15–20
Muwanga CL, Quinton DN, Sloan JP, Gillies P, Dove AF (1986) A new treatment of stable lateral ligament injuries of the ankle joint. Injury 17(6):380–382
Rucinkski TJ, Hooker DN, Prentice WE, Shields EW, Cote-Murray DJ (1991) The effects of intermittent compression on edema in post acute ankle sprains. J Orthop Sports Phys Ther 14(2):65–69
Watts BL, Armstrong B (2001) A randomised controlled trial to determine the effectiveness of double Tubigrip in grade 1 and 2 (mild to moderate) ankle sprains. Emerg Med J 18(1):46–50
Wilkerson GB, Horn-Kingery HM (1993) Treatment of the inversion ankle sprain: comparison of different modes of compression and cryotherapy. J Orthop Sports Phys Ther 17(5):240–246
Vin F (1995) The physiology of compression: clinical consequences, precautions and contraindications. Phlebology 10(Suppl. 1):5–8
Blair SD, Wright DD, Backhouse CM, Riddle E, McCollum CN (1988) Sustained compression and healing of chronic venous ulcers. BMJ 297(6657):1159–1161
Brooks SC, Potter BT, Rainey JB (1981) Treatment for partial tears of the lateral ligament of the ankle: a prospective trial. Br Med J 282(6264):606–607
Tufft K, Leaman A (1994) A better form of treatment? Comparison of wool and crepe, and elasticated tubular bandages in the treatment of ankle sprains. Prof Nurse 9(11):745–746
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hansrani, V., Khanbhai, M., Bhandari, S. et al. The role of compression in the management of soft tissue ankle injuries: a systematic review. Eur J Orthop Surg Traumatol 25, 987–995 (2015). https://doi.org/10.1007/s00590-015-1607-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00590-015-1607-4