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Effectiveness of double Tubigrip in grade 1 and 2 ankle sprains
  1. D Lewis1,
  2. P Atkinson2
  1. 1Department of Accident and Emergency Medicine, Bedford NHS Trust, Kempston Road, Bedford MK42 9DJ, UK
  2. 2Department of Accident and Emergency Medicine, Luton and Dunstable NHS Trust, Lewsey Road, Luton LU4 0DZ, UK

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    We were interested to read the paper by Watts and Armstrong1 that looked at the effectiveness of double Tubigrip in grade 1 and 2 ankle sprains. The authors' aim was to carry out a well designed randomised controlled trial that would determine whether functional recovery was achieved more rapidly with double Tubigrip or with no treatment. We have some reservations about their study design, the data collected, and the conclusions. Of the 485 patients who were eligible to enter only 197 completed the trial. This is equal to a 59% drop out rate. Basic validity of a controlled trial requires that at least 70% of those eligible complete the trial.2

    The main outcome measures were crude by any standards. The only significant difference shown by their study was in the need for analgesia. But the question “ did you take pain killers?” can hardly be regarded as a sensitive tool for determining the amount of pain suffered by the patients. Had both groups of patients been issued with blister packs of a standardised analgesic and the number of tablets taken observed then a more accurate estimation of pain suffered could have been made. No attempt was made to re-evaluate the patients for ankle instability, which is the major complication of lateral ligament injuries. If we were …

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