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Rupture of the lateral ligaments of the ankle: operation or plaster cast? A propective study
Niedermann B, Andersen A, Andersen SB, Funder V, Jorgensen JP, Lindholmer E, Vuust M
Acta Orthopaedica Scandinavica 1981;52(5):579-587
clinical trial
3/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The material comprises 444 patients, aged 12 to 50 years, with acute sprain of the ankle, seen over an 11-month period (1 October 1977 to 31 August 1978). Clinical examination showed no rupture of the ligaments in 53. Arthrography in the remaining patients revealed rupture of the lateral ligaments in 209 (in two-thirds of the anterior talofibular ligament and in one-third of the anterior talofibular as well as calcaneofibular ligament). Conservative treatment with a below-knee plaster cast for 5 weeks was employed in 107 patients, while 102 were treated surgically by suture of the ruptured ligament(s) and subsequently wore a below-knee plaster cast for 5 weeks. The follow-up 1 year after the accident was attended by 63% of the patients. Good results were found in 76% of those treated by plaster cast only and in 81% of those treated by surgery. The difference is not statistically significant.

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