Stable Versus Unstable Grade II High Ankle Sprains: A Prospective Study Predicting the Need for Surgical Stabilization and Time to Return to Sports

Stable and unstable grade II syndesmotic injuries require different treatment strategies and vary in functional outcomes: a systematic review

“…Three studies published between 2004 and 2015 were included 11 13 40. Two studies described functional outcomes after conservative treatment11 40 and one study described functional outcomes after both conservative and surgical treatment of grade II syndesmotic injuries 13.…”

“…Two studies described functional outcomes after conservative treatment11 40 and one study described functional outcomes after both conservative and surgical treatment of grade II syndesmotic injuries 13. The Modified Coleman Methodology Score ranged from 49 to 89 (table 1).…”

“…The three studies11 13 40 reported functional outcomes after conservative treatment in 57 patients. All patients were treated within 10 days of initial trauma.…”

“…Complications were reported by two studies11 13 and included anterolateral ankle impingement, soreness and stiffness, all within the first 10 weeks after injury. Calder et al 13 and Wright et al 11 reported that all patients, except for one, were able to resume their previous sporting activities at the same competitive level. The overall average time to return to sports after conservative treatment was 39 days (range 6–90 days) (table 4).…”

“…Calder et al 13 reported functional outcomes after surgical treatment in 36 patients with unstable grade II injuries. The indications for surgery included a positive squeeze test with a positive external rotation test, tenderness on palpation over the anterior interosseous membrane more than 6 cm proximal to the ankle joint, and injury to the deltoid ligament or posterior inferior tibiofibular ligament on MRI.…”