***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background : Lateral ligament ankle sprains are the single most common sports injury . Objective : To determine the functional outcome of the ankle joint after a moderate or severe inversion injury , comparing st and ard treatment with an elastic support b and age against an Aircast ankle brace . Design : Prospect i ve , r and omised controlled trial . Setting : Two accident and emergency departments . Method : Fifty patients presenting consecutively were r and omised into two equal groups : one group was treated with an elastic support b and age and the other with an Aircast ankle brace . All patients were given a st and ardised advice sheet referring to rest , ice , compression , and elevation . Patients were review ed after 48–72 hours , 10 days , and one month . Primary outcome measure : Ankle joint function assessed at 10 days and one month using the modified Karlsson scoring method ( maximum score 90 ) . Secondary outcome measure : The difference in ankle girth ( swelling ) and pain score at 10 days . Results : Seventeen patients in the elastic support b and age group ( six defaulted , two excluded ) and 18 patients in the Aircast ankle brace group ( six defaulted , one excluded ) completed the study . There were no significant differences between the two groups at presentation in terms of age ( mean 35.3 and 32.6 years respectively ) , sex , dominant leg , left or right ankle injured , previous injury , time to presentation ( median three and four hours respectively ) , difference in ankle girth ( mean 14.5 and 14.3 mm respectively ) , and pain scores ( mean 6.2 and 5.8 respectively ) . The Karlsson score was significantly higher in the Aircast ankle cast group than in the elastic b and age group at 10 days ( mean 50 v 35 , p = 0.028 , 95 % confidence interval ( CI ) 1.7 to 27.7 ) and one month ( mean 68 v 55 , p = 0.029 , 95 % CI 1.4 to 24.8 ) ( Student ’s t test ) . There was no difference between the groups in the secondary outcome measures ( swelling , p = 0.09 ; pain , p = 0.07 ) . When hierarchical multiple regression analysis was used to correct for possible baseline confounding factors , the Aircast ankle brace group was significantly associated with higher Karlsson scores at 10 days ( p = 0.009 ) and one month ( p = 0.024 ) . Conclusion : The use of an Aircast ankle brace for the treatment of lateral ligament ankle sprains produces a significant improvement in ankle joint function at both 10 days and one month compared with st and ard management with an elastic support b and age Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more The purpose of this study was to examine a young athletic population to up date the data regarding epidemiology and disability associated with ankle injuries . At the United States Military Academy , all cadets presenting with ankle injuries during a 2-month period were included in this prospect i ve observational study . The initial evaluation included an extensive question naire , physical examination , and radiographs . Ankle sprain treatment included a supervised rehabilitation program . Subjects were reevaluated at 6 weeks and 6 months with subjective  assessment , physical  examination  , and functional testing . The mean age for all subjects was 20 years ( range , 17–24 years ) . There were 104 ankle injuries accounting for 23 % of all injuries seen . There were 96 sprains , 7 fractures , and 1 contusion . Of the 96 sprains , 4 were predominately medial injuries , 76 were lateral , and 16 were syndesmosis sprains . Ninety-five percent had returned to sports activities by 6 weeks ; however , 55 % of these subjects reported loss of function or presence of intermittent pain , and 23 % had a decrement of > 20 % in the lateral hop test when compared with the uninjured side . At 6 months , all subjects had returned to full activity ; however , 40 % reported residual symptoms and 2.5 % had a decrement of > 20 % on the lateral hop test . Neither previous injury nor ligament laxity was predictive of chronic symptomatology . Furthermore , chronic dysfunction could not be predicted by the grade of sprain ( grade I vs. II ) . The factor most predictive of residual symptoms was a syndesmosis sprain , regardless of grade . Syndesmosis sprains were most prevalent in collision sports . This study demonstrates that even though our knowledge and underst and ing of ankle sprains and rehabilitation of these injuries have progressed in the last 20 years , chronic ankle dysfunction continues to be a prevalent problem . The early return to sports occurs after almost every ankle sprain ; however , dysfunction persists in 40 % of patients for as long as 6 months after injury . Syndesmosis sprains are more common than previously thought , and this confirms that syndesmosis sprains are associated with prolonged disability In this r and omised controlled trial , we evaluated the role of elastic compression using ankle injury stockings ( AIS ) in the management of fractures of the ankle . A total of 90 patients with a mean age of 47 years ( 16 to 79 ) were treated within 72 hours of presentation with a fracture of the ankle , 31 of whom were treated operatively and 59 conservatively , were r and omised to be treated either with compression by AIS plus an Aircast boot or Tubigrip plus an Aircast boot . Male to female ratio was 36:54 . The primary outcome measure was the functional Olerud-Mol and er ankle score ( OMAS ) . The secondary outcome measures were ; the American Orthopaedic Foot and Ankle Society score ( AOFAS ) ; the Short Form (SF)-12v2 Quality of Life score ; and the frequency of deep vein thrombosis ( DVT ) .  Compression using AIS reduced swelling of the ankle at all time points and improved the mean OMAS score at six months to 98 ( 95 % confidence interval ( CI ) 96 to 99 ) compared with a mean of 67 ( 95 % CI 62 to 73 ) for the Tubigrip group ( p < 0.001 ) . The mean AOFAS and SF-12v2 scores at six months were also significantly improved by compression . Of 86 patients with duplex imaging at four weeks , five ( 12 % ) of 43 in the AIS group and ten ( 23 % ) of 43 in the Tubigrip group developed a DVT ( p = 0.26 ) . Compression improved functional outcome and quality of life following fracture of the ankle . DVTs were frequent , but a larger study would be needed to confirm that compression with AISs reduces the incidence of DVT Objective Acute lateral ankle sprain accounts for 85 % of all sprains , being generally accepted as the most common sports-related ligamentous injury . There is a lack of consensus about the optimal management of these injuries despite their frequency . The time-honoured mantra of rest , ice , elevation and compression is still commonly used , even though the current evidence for compression is conflicting . Methods A prospect i ve r and omized controlled clinical trial was carried out in the emergency department of a regional hospital in Irel and to compare outcomes , in terms of ankle function , pain improvement and return-to-work times , in adults presenting within 24 h of first-time acute lateral ankle sprain , among three external supports . Results We found no statistically significant differences among all three treatments in terms of ankle joint function , using the Karlsson ankle function scale , at 10 or 30-days follow-up . There was a tendency for Elastoplast b and aging to provide better average ankle function at both time points , when compared with double tubigrip and no support . Participants returned to work an average 2 days earlier , if treated with Elastoplast . Conclusion This study found no statistically significant difference in ankle function between double tubigrip b and age , Elastoplast b and age and no support at 10 or 30-days follow-up 1 . The pressure exerted by two types of b and age used to treat sprained ankles were compared in a study . 2 . Wool and crepe b and ages exert more pressure than elasticated tubular b and age , but this advantage is likely to be short lived . 3 . Neither b and age exerts significant pressure over the sprained ligament OBJECTIVE To compare functional outcome in patients with acute grade 1 or 2 ( mild to moderate ) lateral ankle sprains r and omised to treatment with or without a double tubigrip b and age ( DTG ) .  METHODS 400 patients presenting to the accident and emergency ( A&E ) departments of a teaching hospital and a district general hospital and diagnosed with grade 1 or 2 lateral ankle sprains were r and omised to treatment with or without a DTG b and age .  A st and ardised telephone question naire was performed one week after presentation . The main outcome measures were : number of days until walking unaided , number of days off work , whether the injury kept the patient awake at night , whether analgesia was taken . RESULTS 197 of 400 patients completed follow up . There were no significant differences in terms of age , sex and occupation between the treatment groups . There were no significant differences between those who did and those who did not complete follow up . There was no significant difference between the treatment groups for number of days until walking unaided ( 95 % CI -0.21 to 0.88 days ) , number of days off work ( 95 % CI -0.70 to 1.02 days ) or whether the injury kept the patient awake at night ( 95 % CI -10 to 17 % ) . There was a significant difference between the groups in the use of analgesia ( 95 % CI 10 to 36 % ) ; the difference seemed to be that patients treated with DTG required significantly more analgesia . CONCLUSIONS Treatment of grade 1 and 2 ankle sprins with DTG does not seem to lead to a shorter time to functional recovery and may increase the requirement for analgesia BACKGROUND Ankle sprains are common and generally believed to be benign and self-limiting . However , a significant proportion of patients with ankle sprains have persistent symptoms for months or even years . AIMS The study aim ed to evaluate whether elastic stockings improve recovery following ankle sprain . METHODOLOGY All patients within 72 h of ankle sprain were identified in Accident & Emergency or the Fracture Clinic . Consenting patients , stratified for sex , were r and omised to either : ( i ) Tubigrip or ( ii ) class II below knee elastic stockings ( ESs , Medi UK Ltd. ) which were fitted immediately and worn until the patient was pain-free and fully mobile . The deep veins of the injured legs were imaged by duplex Doppler for deep vein thrombosis ( DVT ) at 4 weeks . Outcome was compared using the American Orthopaedic Foot and Ankle Score ( AOFAS ) and SF12v2 for quality of life . RESULTS In the 36 r and omised patients , the mean ( 95 % confidence interval ( CI ) ) circumference of the injured ankle treated by ES was 23.5 (23 - 24)cm initially and 22 ( 22 - 23 ) and 22 (21 - 22.5)cm at 4 and 8 weeks ( p<0.001 ) compared with 24 ( 23 - 25 ) cm initially and 24 ( 23 - 25 ) and 24 ( 23 - 24.5 ) cm using Tubigrip ( p<0.001 ) . By 8 weeks , the mean AOFAS and SF12v2 scores were significantly improved by ES at 99 ( 8.1 ) and 119 ( 118 - 121 ) compared with 88 ( 11 ) and 102 ( 99 - 107 ) with Tubigrip ( p<0.001 ) . Of the 34 duplex images at 4 weeks , none had a DVT . CONCLUSION Elastic compression improves recovery following ankle sprain BACKGROUND Severe ankle sprains are a common presentation in emergency departments in the UK . We aim ed to assess the effectiveness of three different mechanical supports ( Aircast brace , Bledsoe boot , or 10-day below-knee cast ) compared with that of a double-layer tubular compression b and age in promoting recovery after severe ankle sprains . METHODS We did a pragmatic , multicentre r and omised trial with blinded assessment of outcome . 584 participants with severe ankle sprain were recruited between April , 2003 , and July , 2005 , from eight emergency departments across the UK . Participants were provided with a mechanical support within the first 3 days of attendance by a trained health-care professional , and given advice on reducing swelling and pain . Functional outcomes were measured over 9 months . The primary outcome was quality of ankle function at 3 months , measured using the Foot and Ankle Score ; analysis was by intention to treat . This study is registered as an International St and ard R and omised Controlled Trial , number IS RCT N37807450 . RESULTS Patients who received the below-knee cast had a more rapid recovery than those given the tubular compression b and age . We noted clinical ly important benefits at 3 months in quality of ankle function with the cast compared with tubular compression b and age ( mean difference 9 % ; 95 % CI 2.4 - 15.0 ) , as well as in pain , symptoms , 
    Output:
    
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 .