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Level of Evidence: V, Expert Opinion

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The main goal in nonoperative treatment of lateral ankle ligament injuries is the reduction of the possible supination at the ankle joint complex. Complete ligament healing can only be achieved when protected from overstress. There is general agreement that talar tilt should be avoided. Recent reports, however, have shown that instability of the ankle joint is at least in one form an axial rotational one. Therefore, the reduction of tibial rotation should also be taken into consideration. The purpose of this study was to determine the effect of three commonly used ankle braces and ankle taping on rotational stability of the ankle joint complex. The Künzli stabilizing shoe was the only orthosis that stabilized sufficiently the ankle joint complex when the foot was in slight plantarflexion. The reduction of external tibial rotation was in foot flexion of 20 degrees: Künzli stabilizing shoe, 58%; Aircast, 23%; Mikros, 12%; and taping, 10%. This becomes more relevant as this foot position is the most dangerous one where most of the ligament injuries does occur. It could be that the insufficient effect of various ankle braces on rotational stability may be the reason for residual problems after ankle sprain.