Management of Acute Grade Ii Lateral Ankle Sprains With an Emphasis on Ligament Protection: A Descriptive Case Series

Abstract

Background and Purpose: Lateral ankle sprain the most common injury in physically active populations. Individuals who sustain an acute lateral ankle sprain may not receive timely formal rehabilitation and are at an increased risk to have subsequent sprains which can lead to chronic pain and instability. Attention to essential factors for ligament protection and healing while preserving ankle movement, may result in a more stable yet mobile ankle offering improved outcomes. The purpose of this case series was to describe the methods and observe the outcomes associated with a comprehensive strategy for managing acute first episode grade II lateral ankle sprains. Study design: Prospective case series. Case Descriptions and Interventions: Ten patients (mean age 26.7 years, range 16-51 years, mean 2.3 days from injury) with acute grade II lateral ankle sprain were treated with an approach to protect the injured ligament, prevent impairments to movement, restore strength and proprioception, and progress to full function. Patient outcomes were assessed at four, eight and 12 weeks. Follow-up interviews at six and 12 months assessed injury recurrence. Outcomes: Patients were treated for an average of eight sessions over a mean of seven weeks. Rapid change in selfreported function, ankle ROM, and pain were observed in the first four weeks of care. Clinically meaningful improvements in function and ankle ROM were also noted at eight weeks and maintained at 12-week follow-ups. All patients returned to desired physical activity with only a single re-sprain event within one year after injury. Conclusion: The results of this prospective case series suggest that a treatment approach designed to protect the injured ligament, maintain and restore normal ankle motion, and provide a tailored functional pathway to return to run and sport demonstrated resolution of symptoms and improvement in reported functional outcomes in a group of patients following grade II acute primary ankle sprain.

Prognostic of Recurrence of Ankle Sprain Injury in Athletes who Return to Sports Early

“…Regarding the presence or absence of other prognostic factors that can disrupt the healing process, only age was found as a consistent prognostic factor. 11,15,17,18 Result and the result presented We can provide an explanation to the patient about the possibility of ankle sprain recurrence. However, whether early return to sport causes recurrence still needs to be studied.…”

“…The use of an ankle brace prevents the recurrence of ankle injuries when exercising, which is evident from the report of one subject who returned to running without using an ankle brace and suffered repeated injuries to the same ankle. 18 The four articles used in the EBCR did not mention whether returning to sports early can lead to the recurrence of ankle sprains. Even so, these EBCR articles are well summarized and can be used to answer the patient's questions regarding ankle sprain injury recurrence and the average time to return to sports.…”

Therapeutic Approach in the Reduction of Chronic Ankle Instability Risk in Adults

“…When viewed categorically, LAS are the injuries most seen in competitive and recreational physical activities [9][10][11] , high school and college athletes, and the military 12 . These injuries account for 75% of all ankle injuries 5 , roughly 50% of all lower extremity injuries seen in adolescents and young adults 7,13,14 , and 36% of all sports-related musculoskeletal injuries 3 . Over half go untreated.…”

Chronic lateral ankle instability: a current concepts review

“…Recent literature reported poor response to conservative management in patients with mechanical instability, unlike functional instability. [5][6][7][8][9] There is much renewed interest in the surgical management of CLAI. This is partly due to the recent advances in minimally invasive and arthroscopic surgery.…”