A retrospective review of the clinical records and radiographs of 1344 ankle sprains occurring over a 41-month period at the United States Military Academy was performed. The incidence and severity of these sprains did not differ significantly from other studies with the exception of those injuries involving the tibiofibular ligaments. Those patients sustaining incomplete injuries to the ankle syndesmosis had a recovery time of almost twice that of those patients with severe (3rd degree) ankle sprains (55 vs. 28 days). Eight of 13 patients with 10 of 15 incomplete syndesmosis injuries were available for follow-up examination and radiographs at an average time of 20 months postinjury (range of 7-39 months). All patients with this injury had a positive "squeeze test" (compression of the fibula to the tibia at mid-calf) at the time of initial examination. Nine of 10 patients developed ossification of the syndesmosis in follow-up radiographs. None of these patients had developed chronic ankle instability, loss of motion, or arthritic changes of the joint at the time of final followup.

A prospective study evaluating nonoperative treatment versus arthroscopic Bankart suture repair for acute, initial dislocation of the shoulder was undertaken in young athletes. All patients met the following criteria: 1) sustained an acute first-time traumatic anterior dislocation, 2) no history of impingement or occult subluxation, 3) the dislocation required a manual reduction, and 4) no concomitant neurologic injury. Thirty-six athletes (average age, 20 years) met the criteria for inclusion. Group I patients were immobilized for 1 month followed by rehabilitation; they were allowed full activity at 4 months. Group II patients underwent arthroscopic Bankart repair followed by the same protocol as Group I. Group I consisted of 15 athletes. Twelve patients (80%) developed recurrent instability; 7 of the 12 have required open Bankart repair for recurrent instability. Group II consisted of 21 patients; 18 patients (86%) had no recurrent instability at last followup (average, 32 months; range, 15 to 45) (P = 0.001). One patient in Group II has required a subsequent open Bankart repair to treat symptomatic recurrence (P = 0.005). In this study, arthroscopic Bankart repair significantly reduced the recurrence rate in young athletes who sustained an acute, initial anterior dislocation of the shoulder.

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This randomized clinical study was designed to prospectively determine the efficacy of a semirigid ankle stabilizer in reducing the frequency and severity of acute ankle injuries in basketball. Athletic shoe, playing surface, athlete-exposure, ankle injury history, and brace assignment were either statistically or experimentally controlled. Participants in the study were 1601 United States Military Academy cadets with no preparticipation, clinical, functional, or radiographic evidence of ankle instability. Subjects experienced a total of 13,430 athlete-exposures in the 1990 and 1991 intramural basketball seasons. Ankle injury was defined as acute trauma to the ankle ligaments that resulted in an athlete's inability to participate in basketball 1 day after the injury. Use of ankle stabilizers significantly reduced the frequency of ankle injuries. Reduction in ankle injuries, however, depended on the nature of injury (fewer contact injuries occurred among those who wore braces). Injury severity was not statistically reduced, and wearing the ankle stabilizer did not affect the frequency of knee injuries. Attitude toward ankle stabilizer use improved as use of the stabilizer increased.