J Korean Foot Ankle Soc.  2019 Sep;23(3):105-109. 10.14193/jkfas.2019.23.3.105.

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

  • 1Department of Orthopedic Surgery, Inje University Sangye Paik Hospital, Seoul, Korea. sybae99@gmail.com
  • 2Department of Orthopedic Surgery, Changwon Himchan Hospital, Changwon, Korea.


To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain.
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.
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.
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.


Ankle; Acute sprain; Cast immobilization; Functional treatment

MeSH Terms

Ankle Injuries*
Follow-Up Studies
Medical Records
Retrospective Studies*
Sprains and Strains


  • Figure 1 Treatment algorithm.

  • Figure 2 Percentage of remnant symptom at 3 weeks after initial visit.

  • Figure 3 Percentage of remnant symptom at last visit.


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