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Three Part Question

In [patients with grade 1 or 2 ankle sprain] is [double tubigrip support better than no tubigrip at all] at [decreasing pain and reducing time to full recovery]?

Clinical Scenario

A 40 year old female attends the Accident and Emergency department with a painful and swollen ankle after sustaining an inversion injury. The patient is seen within the minor injuries unit. Examination reveals no bony tenderness and a diagnosis of grade 2 sprain is made. You wonder whether the application of tubigrip support will be helpful to reduce pain and shorten the recovery time.

Search Strategy

Medline 1966-week 3/09/04 using the OVID interface.
[exp ankle injuries OR (ankle.mp AND {exp soft tissue injuries OR exp "sprains and strains"})] AND [tubigrip.mp OR tubular$.mp. OR elastic compression bandage.mp OR compression bandage.af.] LIMIT to human AND English.

Search Outcome

10 papers were found of which 8 were irrelevant to the study question

Relevant Paper(s)

Author, date and country	Patient group	Study type (level of evidence)	Outcomes	Key results	Study Weaknesses
Linde F et al, 1984, Denmark	100 patients with acute ankle sprain	Prospective cohort study	No statistical difference in inflammatory score or swelling	No statistical difference between DTG and no DTG	No power study No randomisation
Watts BL and Armstrong B, 2001, UK	400 patients with grade 1 or 2 lateral ankle sprain were randomised to treatment with or without a double tubigrip bandage.	PRCT	Mobility	No significant difference	Approximately 50% patients lost during the follow-up
			Days off work	No significant difference
			Pain	Increased need for analgesia in tubigrip group
			Awake at night because of pain	No significant difference

Comment(s)

There is one randomised trial and one prospective cohort study which answers the question.

Clinical Bottom Line

The evidence available suggests that the use of double tubigrip in grade 1 or 2 ankle sprains does neither reduce pain nor shortens recovery time.

References

1. Linde F, Hvass I, Jurgensen U et al. Compression bandage in the treatment of ankle sprains. A comparative prospective study. Scandinavian Journal of Rehabilitation Medicine 1984;16(4):177-9.
2. Watts BL, Armstrong B. A randomised controlled trial to determine the effectiveness of double tubigrip in grade 1 or 2 (mild to moderate) ankle sprains. Emerg Med Journal 2001;18(1):46-50.