Cast immobilisation or vacuum stabilizing system?

In a prospective randomized trial the early functional results after immobi lisation in a cast were compared to those after using a vacuum stabilizing system. The vacuum stabilizing system Vacoped(R) offers equivalent stabilit y compared to a plaster cast. In contrast to the cast the Vacoped can be re moved for body care and physical therapy. Additionally the range of motion for dorsalflexion/extension in the upper ankle joint can be adjusted. From 9/1996 to 7/1997 there were 40 patients included in the study with an opera ted ankle fracture as monotrauma. Six weeks postoperatively the patients wi th cast treatment showed significantly higher functional deficits for the u pper ankle joint (20%), the lower ankle joint (40%) and muscle atrophy (2.1 cm side difference) than the group with the vacuum stabilizing system (upp er ankle joint 15%, lower ankle joint 25%, 1.4 cm muscle atrophy). Five pat ients out of the group with the vacuum system were already at work three we eks postoperatively. Three months postoperatively the functional results fo r both groups were approximating. The vacuum stabilizing system Vacoped(R) offers better early functinal results than conventional cast treatment afte r osteosynthesis of ankle fractures. Because of the increased patient comfo rt and the early ability for physical therapy the vacuum stabilizing system is preferable to cast treatment.