Surgical versus conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults

Kerkhoffs, GMMJ; Handoll, HHG; Bie, Rob de; Rowe, BH; Struijs, PAA

doi:10.1002/14651858.cd000380

Cited by 78 publications

(88 citation statements)

References 36 publications

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“…5,9,13 A Cochrane review of 20 randomized controlled trials involving 2262 patients found insufficient evidence to determine the relative effectiveness of surgery versus conservative therapy for lateral ankle injuries. 16 We found no evidence regarding the relative effectiveness of surgery versus conservative therapy for peroneal injuries.…”

Section: Imagingmentioning

confidence: 75%

Split Peroneus Brevis Tendon: An Unusual Cause of Ankle Pain and Instability

Chauhan

Panchal

Szabo

et al. 2014

The Journal of the American Board of Family Medicine

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Tears of the peroneus brevis tendon may cause ankle pain, swelling, and instability. Supportive therapy with ankle bracing and analgesics is the mainstay of therapy, but surgical repair is often required in patients with ongoing symptoms. Surgical options include debridement, tubularization, or, in severe cases, resection of the damaged tendon and tenodesis. We describe a 64-year-old woman with a split peroneus brevis tendon presenting with lateral ankle pain, swelling, and instability, and we review the literature regarding presentation, diagnostic testing, pathophysiology, predisposing factors, and treatment recommendations. Primary care physicians should consider peroneal tendon injuries in patients with chronic lateral ankle pain and instability. (J Am Board Fam Med 2014;27:297-302.)

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Section: Imagingmentioning

confidence: 75%

Split Peroneus Brevis Tendon: An Unusual Cause of Ankle Pain and Instability

Chauhan

Panchal

Szabo

et al. 2014

The Journal of the American Board of Family Medicine

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“…Despite the low number of studies for each outcome measure, there is some limited evidence that supervised exercises may provide benefit over conventional treatment alone. This review of the literature adds to the reviews of Kerkhoffs et al, 13,14,15 Kannus and Renstróm, 12 and Tiling et al 27 In these reviews the authors concluded that functional treatment (early exercise, the use of an external support, and eventually coordination training) was the treatment of choice for acute lateral ankle sprains. However, they did not differentiate between super vised and nonsupervised (functional) treatment, the objective of this review.…”

Section: Discussionmentioning

confidence: 86%

Comparison of Conventional Treatment and Supervised Rehabilitation for Treatment of Acute Lateral Ankle Sprains: A Systematic Review of the Literature

Os¹,

Bierma-Zeinstra²,

Verhagen³

et al. 2005

J Orthop Sports Phys Ther

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Study Design: Systematic literature review. Objective: To compare the effectiveness of conventional treatment complemented by supervised rehabilitation training (supervised exercises) with conventional treatment alone for the rehabilitation of acute lateral ankle sprains. Background: Conventional treatment is advocated as a preferable treatment strategy. Whether supervised exercises should complement conventional treatment is unclear. Methods and Measures:We searched 5 computerized databases from 1966 to March 2004, checked the reference lists of all studies that fulfilled our eligibility criteria, and searched for nonindexed journals available on the Internet. Three reviewers independently selected randomized controlled trials (RCTs), and controlled clinical trials (CCTs), comparing conventional treatment alone with conventional treatment combined with supervised exercises for treating patients with an acute lateral ankle sprain. Two reviewers independently assessed the methodological quality of each included study. Two reviewers extracted data regarding outcomes, interventions, and results. Follow-up measurements were grouped as (a) immediate term, (b) short term, (c) intermediate term, and (d) long term. A best-evidence synthesis was conducted, weighting the studies with respect to their internal validity and statistical significance of the outcomes. Results: Seven RCTs were included. The quality assessment resulted in 1 high-quality and 6 low-quality studies. There is limited evidence that the addition of supervised exercises to a conventional treatment approach results in greater reduction in swelling and faster return to work. Studies reporting a lack of difference between treatment approach did not report statistical power, making interpretation of those results difficult.

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“…However, surgical intervention also has inherent disadvantages, such as wound infection, iatrogenic nerve injury, and other postsurgical complications. The primary objective of this Cochrane Review is to determine whether surgical management is superior to conservative management of acute lateral ligament complex injuries [6].…”

Section: Cochrane In Corrmentioning

confidence: 99%