Compression Wrapping for Acute Closed Extremity Joint Injuries: A Systematic Review

Vere Borra; David C Berry; David Zideman; Eunice Singletary; Emmy De Buck

doi:10.4085/1062-6050-0093.20

Compression Wrapping for Acute Closed Extremity Joint Injuries: A Systematic Review

J Athl Train. 2020 Aug 1;55(8):789-800. doi: 10.4085/1062-6050-0093.20.

Authors

Vere Borra^{1

2}, David C Berry³, David Zideman⁴, Eunice Singletary⁵, Emmy De Buck^{1

2

6}

Affiliations

¹ Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.
² Cochrane First Aid, Mechelen, Belgium.
³ Department of Kinesiology, College of Health and Human Services, Saginaw Valley State University, University Center, MI.
⁴ Thames Valley Air Ambulance, Stokenchurch, UK.
⁵ Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville.
⁶ Department of Public Health and Primary Care, KU Leuven, Belgium.

Abstract

Objective: Current prehospital recommendations for an acute closed extremity joint injury (ACEJI) are to apply compression in some manner. However, the effectiveness of compression is unclear. We performed a systematic review to summarize and synthesize the evidence for the use of a compression bandage for ACEJI in the prehospital setting.

Data sources: Cochrane Library, PubMed, and Embase were searched for relevant literature in November 2019.

Study selection: Controlled trials involving adults in the prehospital setting with a recent ACEJI were included when compressive, nonimmobilizing interventions, feasible in a first aid setting, were applied and compared with no compression or any noncompressive intervention, such as braces, splints, or noncompressive stockings. Articles in all languages were included if an English abstract was available.

Data extraction: Data on study design, study population, intervention, outcome measures, and methodologic quality were extracted from each included article.

Data synthesis: Eight studies out of 1193 possibly relevant articles were included. All authors examined compression in the treatment of acute ankle sprains; no studies involved compression for the treatment of other ACEJIs. No difference in the major outcomes of pain reduction or swelling, ankle-joint function, or range of motion could be demonstrated. For the outcome of recovery time, no benefit was shown when comparing compression with no compression. Evidence was insufficient to inform a conclusion about the outcomes of time to return to work or sport. All evidence was of low to very low certainty.

Conclusions: The evidence for the use of a compression wrap was limited to patients with closed ankle injuries. In this systematic review, we could not demonstrate either a beneficial or harmful effect from the application of a compression or elastic bandage compared with no compression or a noncompressive stocking, splint, or brace as a first aid treatment in the prehospital environment.

Keywords: first aid; sprains; strains.

Publication types

Systematic Review

MeSH terms

Ankle Injuries / therapy
Compression Bandages*
First Aid* / instrumentation
First Aid* / methods
Foot Injuries / therapy*
Humans
Sprains and Strains
Treatment Outcome