Treatment of acute ankle ligament injuries: a systematic review

Abstract

BackgroundLateral ankle sprains are common musculoskeletal injuries.ObjectivesThe objective of this study was to perform a systematic literature review of the last 10 years regarding evidence for the treatment and prevention of lateral ankle sprains.Data sourcePubmed central, Google scholar.Study eligibility criteriaMeta-analysis, prospective randomized trials, English language articles.InterventionsSurgical and non-surgical treatment, immobilization versus functional treatment, different external supports, balance training for rehabilitation, balance training for prevention, braces for prevention.MethodsA systematic search for articles about the treatment of lateral ankle sprains that were published between January 2002 and December 2012.ResultsThree meta-analysis and 19 articles reporting 16 prospective randomized trials could be identified. The main advantage of surgical ankle ligament repair is that objective instability and recurrence rate is less common when compared with non-operative treatment. Balancing the advantages and disadvantages of surgical and non-surgical treatment, we conclude that the majority of grades I, II and III lateral ankle ligament ruptures can be managed without surgery. For non-surgical treatment, long-term immobilization should be avoided. For grade III injuries, however, a short period of immobilization (max. 10 days) in a below knee cast was shown to be advantageous. After this phase, the ankle is most effectively protected against inversion by a semi-rigid ankle brace. Even grades I and II injuries are most effectively treated with a semi-rigid ankle brace. There is evidence that treatment of acute ankle sprains should be supported by a neuromuscular training. Balance training is also effective for the prevention of ankle sprains in athletes with the previous sprains. There is good evidence from high level randomized trials in the literature that the use of a brace is effective for the prevention of ankle sprains.ConclusionBalancing the advantages and disadvantages of surgical and non-surgical treatment, we conclude that the majority of grades I, II and III lateral ankle ligament ruptures can be managed without surgery. The indication for surgical repair should be always made on an individual basis. This systematic review supports a phase adapted non-surgical treatment of acute ankle sprains with a short-term immobilization for grade III injuries followed by a semi-rigid brace. More prospective randomized studies with a longer follow-up are needed to find out what type of non-surgical treatment has the lowest re-sprain rate.

Assessment of Postural Stability in Young, Physically Active Men With the History of Ankle Sprain

“…W gru pie wszyst kich dys cy plin spor to wych czę stość je go wystę po wa nia wy no si od 15 do 20% [1]. Skut ku je ono nie tyl ko uszko dze niem wię za deł, ale rów nież licznych me cha no re cep to rów znaj du ją cych się w ob rę -bie to reb ki sta wo wej, wię za deł czy też ścię gien komplek su sta wu sko ko we go [2][3][4].…”

Erratum zu: Das instabile Sprunggelenk

“…Insgesamt herrscht derzeit Konsens über die primäre Durchfüh-rung einer individuellen Therapie, die im Regelfall konservativ durchgeführt werden kann [3,5,6].…”

Comparison Between Rigid Double Upright and Lace-up Ankle Braces on Ankle Range of Motion, Functional Performance, and User Satisfaction of Brace Characteristics

“…[9][10][11] Because of the relatively high prevalence and risk of ankle sprain, ankle braces are widely used and have been recognized as an effective prophylactic intervention to reduce the incidence, severity, and recurrence of ankle sprains. 4,[12][13][14][15][16][17][18][19][20][21] There are many different types of ankle braces available commercially, and most can be classified into categories of rigid, semi-rigid, or lace-up based upon their general design. A recent study by Denton et al regarding clinicians' (ie, physical therapists and athletic trainers) recommendations and perceptions associated with ankle brace use reported that lace-up braces were the type of ankle brace that were most frequently recommended prophylactically to prevent ankle sprain injuries.…”