Ankle sprains may not be as ‘simple’ as you think

This study follows more than 200 patients who had been diagnosed with an acute lateral ankle sprain for five years. At follow up almost 20% of these patients (18.2%) experienced ongoing problems with their ankle while about a third (30.3%) had experienced a re-sprain. 

This article demonstrates that a relatively high number of patients have ongoing problems with their ankle at five-year follow-up.1 This finding challenges the common belief that these are relatively benign or ‘simple’ injuries. It is interesting to note that the proportion of patients with ongoing complaints was actually lower in this study than in previous research. This may be attributable to the study methodology. This paper involved the participants completing a questionnaire, with no physical exam or imaging conducted. As a result it may actually under-report the degree of ongoing morbidity post-ankle sprain. Predictors for persistent complaints at 5-year follow-up include the presence of ongoing problems 6 to 12 months after initial injury, an injury involving the dominant leg and a recurrent ankle sprain. 

Another interesting finding was the percentage of participants who re-injured their ankle during the 5-year follow-up period (30%) and the number of participants who have five or more re-sprains. The data also suggests that the majority of re-sprains (approximately two thirds) occurred within the first year of follow-up. 

This study illustrates the need for better education of players who sustain a lateral ankle sprain and an explanation that the incidence of ongoing symptoms is higher than they might expect. It also potentially highlights the need for closer follow up and for more effective treatment of the initial injury. A better focus on injury prevention strategies (which we know are effective) may also reduce the risk of long-term morbidity (given that re-injury has been demonstrated to be a risk factor).

To learn more about the assessment and treatment of ankle pain complete the ‘ankle’ module in the FIFA Diploma in Football Medicine.

References
1. Mailuhua AKE, Oeib EHG, van Putte-Katier N et al. Clinical and radiological predictors for persistent complaints five years after a lateral ankle sprain: A long-term follow-up study in primary care

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Simthandile Toni
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Simthandile Toni

What are the factors that have been found to influence the outcome of an ankle sprain?

drlabelle
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I’m loving these last few fast facts.

Bangoura
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Dans les lésions de la cheville qu’elles soient bénigne ou malignes la prise en charge doit être prompte et efficace Les premiers soins sont primordiaux Devant une lésion de la cheville il faut faire une bonne imagerie qui va nous aider pour le diagnostic clair Faire une RADIOGRAPHIE et approfondir par l IRM SI l intervention chirurgicale s impose il faut la faire avec minutie et réparer tous les dégâts Procéder à une bonne rééducation pour une meilleur reprise des activités sportives SI une chevilleest non ou mal traitée on a toujours la malchance que les douleurs reviennent Donc un… Read more »

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[…] the worldwide governing body for soccer, called attention to the JSMS article in a FIFA Medical blog post in June. The post concluded, “This study illustrates the need for better education of players who sustain […]