1. Role of compression in management of ankle fractures Sultan MJ 1,3,4, Zheng TT 1,3, Hodhody G 1, Kurdy N 2, McCollum CN 1,3,4 1 Academic Vascular Surgery Department, University Hospital of South Manchester (UHSM), 2 Department of Orthopaedic Surgery (UHSM), 3 Department of Vascular Surgery (UHSM), 4 University of Manchester, UK

2. Ankle fractures 60,000/yr in UK NHS acute bed cost - £67million/yr > 70% suffer long term symptoms

3. Ankle fracture randomisen=90 44 46

4. Study plan 0 4 12 26 randomise wks x-ray 8 <72 hrs OMAS AOFAS SF-12 v2 2 1 physiotherapy

5. 115 110 90 4 105 n=42 101 boot + ECS n=43 107 boot ankle circumference index n=85 p<0.001 100 95 08 12 weeks mean 95% CI % of normal 26

6. 5 DVT DVT 88% 12% 77% 23% 43 boot alone patients 43 boot + ECS patients DVT in 15 (18%) of 86 patients 10 DVT P=0.26

7. 100 80 0 48 12 weeks 60 40 20 n=42 98 boot + ECS n=43 67 boot Mean OMAS score n=85 p<0.001 score 26

8. 105 40 80 60 n=43 89 boot n=42 105 boot + ECS Mean AOFAS score n=85 p<0.001 48 12 weeks score 26

9. 120 110 70 100 90 n=43 99 boot n=42 116 boot + ECS Mean SF12 score n=85 P<0.001 80 48 12 weeks score 26

10. In ankle fracture ECS improves functional outcome and QoL DVT is frequent (18%) ? Does ECS prevent DVT