Sixty patients with foot or ankle trauma were randomized and treated in three groups. In intermittent impulse compression, an air pad under the foot was inflated every 20 seconds, thus activating the venous foot pump. In continuous cryotherapy, ice water circulates between the ice box and the cold pad. The ice water was changed once per day. In standard therapy, the injured extremity was treated with cool packs, which were changed 4 times per day. Beginning at admission, every 24 hours the circumference was measured around the ankle, midfoot, and forefoot. After 24 hours of treatment, there was a 47% reduction in swelling with the A-V impulse System, 33% with continuous cryotherapy, and 17% with cool packs. After 4 days of postoperative treatment, the A-V impulse System reduced the swelling by 74% versus 70% with continuous cryotherapy and 45% with cool packs. Both new methods are preferable to cool packs. Because of the better preoperative results, the A-V impulse System proved to be the most effective device.

No abstract

Mid-shaft clavicular fractures have to be classified by the criteria contact and number of fragments. Advantages of operative procedures are early freedom from pain and shoulder function recovery. Non-displaced low grade shaft fractures without shortening should be treated conservatively, whereas displaced low-grade shaft fractures have a better result after intramedullary nailing. Plate fixation should be predominantly used in dislocated and comminuted fractures as well as in patients with a high level of physical activity in their jobs.

A prospective randomised trial of treatment of ruptured ankle ligaments was carried out at our institute. Two hundred patients were randomly assigned to 4 treatment groups. The results at 1 and 2 years after injury showed that functional treatment with a newly designed brace appeared to be the method of choice. This gives good mechanical stability, a shorter time off work and the ability to resume full sporting activity within 3 months of injury. Operation is only indicated for dislocations of the ankle and foot, ankle ligament rupture with additional intraarticular damage and second stage injuries or re-ruptures.