Comparison of the use of evaporative coolants and ice packs for the management of preoperative edema and pain in ankle fractures: a prospective randomized controlled trial

Introduction: The use of evaporative coolants in the management of acute musculoskeletal injury has received increasing attention recently. However, its efficacy compared with conventional cryotherapy in treating injured human subjects remains unclear. The purpose of this study is to compare the efficacy of evaporative coolants with that of ice packs in preoperative management of edema and pain in patients with an ankle fracture. Material and methods: Sixty-three patients in need of surgical treatment for ankle fracture were randomly assigned to either an evaporative coolant group or an ice pack group. Both treatments were applied for 5 days after injury and outcomes were measured daily. The primary outcome was a reduction in edema as measured by the figure-of-eight-20 method and the secondary outcome was measured by visual analog scale (VAS) for pain. Results: Two-way analysis of variance with repeated measures showed no significant group effect and no significant group-by-time interaction in terms of reduction of edema and VAS score for pain between two groups. No adverse effects were reported in either group. Conclusion: Evaporative coolants exhibited comparable efficacy to ice packs in preoperative cryotherapy of ankle fractures without adverse effects. While evaporative coolants are more expensive than ice packs, they can present a viable option for cryotherapy. Level of evidence: Level I, prospective randomized study.