584 patients with severe ankle sprains were recruited from eight emergency departments to assess the effectiveness of three different bracing options and to compare them with a tubular compression brace. Patients were randomized to treatment with a below-knee cast, an Aircast brace, Bledsoe boot, or tubular compression brace. At three month follow-up, there was a significant improvement in the Foot and Ankle scores of the below-knee casting and Airbrace groups in comparison to the tubular compression brace. There were no differences between groups at a nine month follow-up.