Soft-tissue ankle injuries

Abstract

Soft-tissue ankle injuries are extremely common and frequently present in the emergency department or to the general practitioner. The lateral ligament complex is most commonly affected, usually following an injury with the ankle in an inverted, plantar-flexed position. The diagnosis is usually clinical, and delayed examination and reassessment 3—5 days after injury is recommended as pain and swelling hinder accurate assessment immediately following injury. Applying the Ottawa ankle rules can reduce the number of unnecessary radiographs. Treatment is usually non-operative with the focus on controlling ankle swelling and pain, and early restoration of ankle movements. Surgical repair of ligaments may be indicated in certain cases, though the role of surgery in the acute setting remains unclear. In the present review, we discuss the anatomy, mechanism of injury, risk factors, clinical presentation, diagnosis, treatment and outcome of soft-tissue ankle injuries as well as consider how such injuries may be prevented.

Diagnostic accuracy of the Ottawa Ankle and Midfoot Rules: a systematic review with meta-analysis

“…While both have similar acute presentation, these injuries need to be distinguished as they are managed differently 2–4. The reference standard for diagnosing an ankle injury as a sprain or fracture involves the use of imaging, usually plain radiographs 4. However, the routine use of plain radiographs to diagnose an ankle injury contributes significantly to high healthcare costs, increases the waiting time in busy emergency departments and exposes patients to often unnecessary radiation 5.…”