<p class="abstract"><strong>Background:</strong> Ankle<strong> </strong>sprain accounts for 15-20% of sports injuries. They are complex injuries and studies that better delineate the etiology are needed. The accuracy of ultrasound as a diagnostic modality of ankle sprain is comparable to MRI.In this study we evaluated the use of ultrasound in delineating the grade of sprain, with special emphasis of grade 2 sprains.</p><p class="abstract"><strong>Methods:</strong> We prospectively studied 80 ankle sprains of over two years. All the patients with features of ankle sprain were evaluated with high frequency ultrasound. Grade 1 &amp; 2 sprains were included in the study. All the patients were followed up for 1 year. Grade 2 sprains were treated with cast for 6 weeks and evaluated for any residual symptoms and chronicity.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 51 males and 29 females with right ankle injured in 57 patients. Seventy-three patients were injured during their leisure activities and 7 were sports injuries. According to ultrasound grading, there were 58 grade 1 injuries, 22 being grade 2 sprain. All the patients were followed up till 1 year. At the end of one year, 79 patients were recovered well with no residual symptoms.</p><p class="abstract"><strong>Conclusions:</strong> Ultrasonogram effectively differentiates grade 1 from grade 2 and gives a clue for further management. Therefore, we recommend routine use of ultrasonogram for every ankle sprain. For grade 2 sprains, rigid immobilization for 6 weeks gives excellent results with no residual symptoms.</p>

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Background: Chronic ankle sprain due to "sprained ankle syndrome" may be particularly troublesome. Some causes of chronic ankle instability may be symptomatic insufficiency of pathologic laxity, arthro-kinematic changes, degenerative changes, decrease of proprioception and inadequate neuromuscular control. This study was conducted to review our experience with footwear correction of chronic ankle sprains of grade 2 and 3. Methods: Ankles of 280 patients, who had chronic ankle sprains grade 2, grade 3 were considered in this study, to assess results of non-operate treatment. Diagnosis was made with history of pain, swelling on walking, clinical findings of swelling, tenderness on antero-lateral aspect of lateral malleolus. All patients were given 3 days of antiinflammatories, analgesics and footwear modifications. Later patients were advised exercise program. Results: Out of 280 patients, who were regularly followed, 92% people had relief, 3.4% of patients continued footwear as they had associated symptoms, 3.9% of patient continued to have pain maybe obscure or not following doctor orders. Conclusion: The study concludes that lateral elevated foot wear made of micro cellular rubber of 0.75 cm is the choice of treatment for grade 2 and 3 ankle sprains. This foot wear helps in biomechanical correction from varus and also decreases symptoms and signs. Cosmetically acceptable.

Objectives: Treatment of distal tibial fractures using minimally invasive plate osteosynthesis (MIPO) technique may minimise damage to soft tissues and the vascular integrity of bony fragments. This is a study to assess the outcome of patients treated with MIPO technique for distal tibial fractures. Methods: A Prospective study of 30 patients treated for distal tibial fractures using a distal tibial locking plate through the MIPO technique. Clcal and functional outcome was evaluated using Ankle score. Results: There were 24 males and 6 females of mean age 40 years. The mean follow-up period was 14 months. According to the AO classification system, there were 12 patients with 43A type fractures, 10 patients with 43B, and 8 patients with 43C type fractures. Mean time to union was 18 months. There were 5 cases with superficial infections treated successfully using oral antibiotics and no failures of fixation. There were no cases of non-union/delayed union or rotational malalignment. Conclusion: MIPO is an effective method of treatment for distal tibial fractures. The use of indirect reduction techniques and small incisions is technically demanding but decreases surgical trauma to soft tissues.