Long term outcomes of inversion ankle injuries

Abstract

Background:Ankle sprains are common sporting injuries generally believed to be benign and self limiting. However, some studies report a significant proportion of patients with ankle sprains having persistent symptoms for months or even years.Aims:To determine the proportion of patients presenting to an Australian sports medicine clinic who had long term symptoms after a sports related inversion ankle sprain.Methods:Consecutive patients referred to the NSW Institute of Sports Medicine from August 1999 to August 2002 with inversion ankle sprain were included. Exclusion criteria were fracture, ankle surgery, or concurrent lower limb problems. A control group, matched for age and sex, was recruited from patients attending the clinic for upper limb injuries in the same time period. Current ankle symptoms, ankle related disability, and current health status were ascertained through a structured telephone interview.Results:Nineteen patients and matched controls were recruited and interviewed. The mean age in the ankle group was 20 (range 13–28). Twelve patients (63%) were male. Average follow up was 29 months. Only five (26%) ankle injured patients had recovered fully, with no pain, swelling, giving way, or weakness at follow up. None of the control group reported these symptoms (p<0.0001). Assessments of quality of life using short form-36 questionnaires (SF36) revealed a difference in the general health subscale between the two groups, favouring the control arm (p<0.05). There were no significant differences in the other SF36 subscales between the two groups.Conclusion:Most patients who sustained an inversion ankle injury at sport and who were subsequently referred to a sports medicine clinic had persistent symptoms for at least two years after their injury. This reinforces the importance of prevention and early effective treatment.

National Athletic Trainers' Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes

“…Although most athletes return to full activity within 6 weeks of an ankle sprain, a large percentage (4% to 74%) report residual symptoms, including loss of function, repeated injury, and disability. 180,181 Further, many athletes (74%) reported at least 1 residual symptom up to 4 years after injury. 181 Often, an ankle injury is treated as a minor orthopaedic condition; however, in light of these data, clinicians should understand the potential link between ankle injury and CAI.…”

Dynamic balance deficits in individuals with chronic ankle instability compared to ankle sprain copers 1 year after a first-time lateral ankle sprain injury

“…The Star Excursion Balance Test (SEBT) is one of the most commonly utilised measures of dynamic balance in lateral ankle sprain populations, capably identifying those who are at an increased risk of sustaining an ankle sprain injury [4,30], who have a current acute lateral ankle sprain injury [7], who are proceeding along the recovery trajectory of this injury [6], and who develop the chronic sequalae of chronic ankle instability [2,13,14,16]. However, despite the tendency for a high proportion of individuals to develop chronic ankle instability following an acute lateral ankle sprain (up to 74%) [1], some recover from this injury with no symptom progression. The existence of these individuals, who have been labelled lateral ankle sprain copers [34], has given rise to a hypothesis that recovery following lateral ankle sprain injury is dependent on the sensorimotor control strategies adopted post-injury [7,9].…”

Variación de la velocidad del centro de presiones en deportistas con esguince lateral de tobillo

“…Después de un esguince lateral externo, los síntomas agudos suelen mejorar en pocas semanas, pero algunos deportistas continúan con dolor, sensación de inestabilidad y edema crónico 4 . La inestabilidad crónica de tobillo se estima que afecta al 10-30% de lesiones agudas y es pobremente entendido por investigadores y clínicos, dando lugar a incoherencias en terminología, definiciones e hipótesis y resultados contradictorios en investigación 2,4,5 . Se estima que los problemas residuales pueden persistir durante décadas, y muchos deportistas, no pueden volver a su nivel anterior de actividad por persistir sus síntomas 2,6,7,8 .…”