Page 196 - HA Convention 2015

Service Priorities and Programmes Free Papers

SPP8.5 Young Hospital Authority Investigators Presentations 14:30 Room 221

A Clinical Trial on Evaluating the Effectiveness of Vasopneumatic and Conventional Cryotherapies on Ankle
Fracture Cases
Ng PH, Sun LS, Chan HM, Li KY
Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Hong Kong

Introduction

Ankle swelling is a common clinical problem in ankle fracture patients and also a leading factor of ankle pain exaggeration.
Cryotherapy is one of the swelling control measures and intermittent ice pack has been used for years. Recently, a new
“vasopneumatic cryotherapy” is advocated to provide a better swelling control with the combination of continuous
compression and cryotherapy. However, no high level studies were carried out to examine its effectiveness on fracture ankle
cases.

Objectives
To evaluate the effectiveness of vasopneumatic and conventional cryotherapies on fracture ankle cases.

Tuesday, 19 May Methodology

A qausi-experimental, prospective, parallel and open labelled study design was conducted with ethical approval endorsed.
Only emergency cases with closed and stable unilateral ankle fracture in Department of Orthopaedics and Traumatology of
Queen Elizabeth Hospital were recruited. Cases were randomised into experimental or conventional group. In experimental
group, low compression pressure was started and stepped up to moderate if patients tolerated. In conventional group, ice
pack was applied three times daily and 20 minutes each. Two clinical outcomes were examined. They were reduction in ankle
girth (primary outcome) and pain intensity (secondary outcome) which were measured every 12 hours with “figure of eight”
and visual analogue scale respectively during first 72 hours.

Results

From March to November 2014, 22 patients were recruited. After randomisation, 12 patients were assigned to experimental
group and 10 to conventional Group. There were no significance differences in demographic data between groups. For
primary outcome, experimental group showed more reduction in whole study period with mean difference of 7.39%. However,
no significant differences were found. Importantly, it showed longer lasting effect and only took 24 hours to attain the similar
reduction effect of conventional group in 36 hours, which implied that experimental group gained 12 hours. For secondary
outcome, mean total reduction were 70.9% in experimental group and 49.6% in conventional group. Significant differences
were found in first 48 hours with average mean differences of 21.34%. Vasopneumatic cryotherapy is more effective and
beneficial to ankle fracture cases. It should be applied at least 48 hours since admission as a cryotherapy protocol for better
patient outcomes. Vasopneumatic cryotherapy also eliminates the nursing procedure of reapplication of crepe bandage
and slab in every conventional cryotherapy. Manipulation to fracture site is minimised. Better patient safety is safeguarded
particularly for unstable fracture cases.

HOSPITAL AUTHORITY CONVENTION 2015

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