Applied Evidence

MSK injury? Make splinting choices based on the evidence

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From The Journal of Family Practice | 2018;67(11):678-683.

References

Evidence: A conservative management strategy for an isolated injury is generally adequate to allow for sufficient healing, and “return to play” without prolonged disability. With conservative management, the affected joint is protected with a hinged knee brace for about 3 to 6 weeks.19,20 Data gathered on patients 9 years postinjury support the use of bracing of grades 1 to 2 injuries, but it is unclear what the optimal strategy is for grade 3 injuries.19

Harms: Generally well tolerated, and no harms have been reported.

Bottom line: Isolated grades 1 to 2 MCL injuries can be treated conservatively, and a hinged knee brace should be used as part of the rehabilitative process. It is unclear how to optimally manage grade 3 injuries.

Lateral ankle sprain

Lateral ankle sprains involve inversion injury to 1 or more of the 3 lateral ankle ligaments. Injuries are graded using the same grade schema as MCL injuries.

Goal of splinting: There are a variety of braces designed to provide lateral stability to patients with lateral ankle sprains. These stirrup braces differ in degree of support and additional fixation points—rigid (pneumatic) vs semirigid (Velcro, lace-up, etc) (FIGURE 7).

Ankle braces IMAGE COURTESY OF: GEOFFREY A. MCLEOD, DO, CAQSM

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