Functional treatment for acute ankle sprains: Softcast wrap versus MOK-cast. A prospective randomized single-center trial

J. K.G. Louwerens*, D. T. Mensch, O. J.W. Verhoof, P. R. de Reuver, T. S. Bijlsma, A. van Noort, M. P.J. van den Bekerom

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background: The outcome of a removable (MOK-cast) versus a non-removable polyester wrap for acute lateral ankle ligament injury is unknown. Methods: Patients with grade II–III lateral ankle ligament injuries were randomized between treatment with a MOK-cast and a wrap. Primary outcome is the Karlsson score for function. Secondary outcomes are patient satisfaction and pain at 4 months follow-up. Results: Randomisation resulted in 53 and 54 patients per arm. Four month follow up was completed by 92% (n = 100). The mean Karlsson score improved from 20 to 87 (p < 0.01) in the wrap group and 20 to 90 (p < 0.01) in the MOK-cast group. In the MOK-cast group treatment satisfaction was higher (8.2 vs 7.8 p 0.04). Reported pain was higher in the first thirty days after injury (p < 0.01). Conclusions: Both wrap and MOK-cast are effective functional treatment options in acute lateral ankle ligament injury. MOK-cast is associated with increased patient satisfaction but higher VAS pain scores. Level of evidence: I.

Original languageEnglish
Pages (from-to)482-487
Number of pages6
JournalFoot and Ankle Surgery
Issue number4
Publication statusPublished - Aug 2019
Externally publishedYes


Neither the authors nor a member of their immediate families received or will receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, centre, clinical practice, or other charitable or non-profit organization with which the authors, or a member of their immediate families, are affiliated or associated. There are no non-financial competing interests (political, personal, religious, ideological, academic, intellectual, commercial or any other) to declare in relation to this manuscript. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

FundersFunder number
centre, clinical


    • Ankle
    • Brace
    • Injury
    • Ligament
    • Sport
    • Treatment


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