Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지
DOI QR코드

DOI QR Code

Evidence-based Treatment of Acute Lateral Ankle Sprain

근거에 기반한 급성 발목관절 외측 염좌의 치료

  • Cho, Byung-Ki (Department of Orthopedic Surgery, Chungbuk National University College of Medicine)
  • 조병기 (충북대학교 의과대학 정형외과학교실)
  • Received : 2018.09.18
  • Accepted : 2018.11.06
  • Published : 2018.12.15
Download PDF
⟨ Previous Next ⟩

Abstract

Acute lateral ankle sprain, which is the most common musculoskeletal injury, can be treated effectively with appropriate evidence-based initial care using PRICE (protection, rest, ice, compression, and elevation) and functional rehabilitation. Many systemic reviews reporting a high-level of evidence supporting the clinical usefulness and necessity of primary surgical repair for acute lateral ankle sprain have been insufficient. Regardless of the severity of ligament complex injuries, the surgical treatment for acute lateral ankle sprain without concomitant pathologies is not recommended and should be considered only in young professional athletes with complete ligament rupture (grade III) and severe instability.

Keywords

References

  1. DiGiovanni CW, Brodsky A. Current concepts: lateral ankle instability. Foot Ankle Int. 2006;27:854-66. https://doi.org/10.1177/107110070602701019
  2. Waterman BR, Owens BD, Davey S, Zacchilli MA, Belmont PJ Jr. The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am. 2010;92:2279-84. https://doi.org/10.2106/JBJS.I.01537
  3. Kerkhoffs GM, Handoll HH, de Bie R, Rowe BH, Struijs PA. Surgical versus conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults. Cochrane Database Syst Rev. 2007;(2):CD000380.
  4. van den Bekerom MP, Kerkhoffs GM, McCollum GA, Calder JD, van Dijk CN. Management of acute lateral ankle ligament injury in the athlete. Knee Surg Sports Traumatol Arthrosc. 2013;21:1390-5. https://doi.org/10.1007/s00167-012-2252-7
  5. Sung KS, Park JM. Acute ankle sprains. Arthrosc Orthop Sports Med. 2016;3:11-7. https://doi.org/10.14517/aosm15012
  6. Hubbard TJ. Ligament laxity following inversion injury with and without chronic ankle instability. Foot Ankle Int. 2008;29:305-11. https://doi.org/10.3113/FAI.2008.0305
  7. Kim HJ. Conservative management of ankle sprains. J Korean Orthop Assoc. 2014;49:7-12. https://doi.org/10.4055/jkoa.2014.49.1.7
  8. O'Neill PJ, Parks BG, Walsh R, Simmons LM, Miller SD. Excursion and strain of the superficial peroneal nerve during inversion ankle sprain. J Bone Joint Surg Am. 2007;89:979-86. https://doi.org/10.2106/00004623-200705000-00009
  9. Coughlin MJ, Saltzman CL, Anderson RB, Mann RA. Mann's surgery of the foot and ankle. 9th ed. Philadelphia: Elsevier; 2014.
  10. Jacobson JA. Musculoskeletal sonography and MR imaging. A role for both imaging methods. Radiol Clin North Am. 1999;37:713-35. https://doi.org/10.1016/S0033-8389(05)70125-1
  11. Cho JH, Lee DH, Song HK, Bang JY, Lee KT, Park YU. Value of stress ultrasound for the diagnosis of chronic ankle instability compared to manual anterior drawer test, stress radiography, magnetic resonance imaging, and arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2016;24:1022-8. https://doi.org/10.1007/s00167-015-3828-9
  12. Balduini FC, Tetzlaff J. Historical perspectives on injuries of the ligaments of the ankle. Clin Sports Med. 1982;1:3-12.
  13. Dias LS. The lateral ankle sprain: an experimental study. J Trauma. 1979;19:266-9. https://doi.org/10.1097/00005373-197904000-00009
  14. Jackson DW, Ashley RL, Powell JW. Ankle sprains in young athletes. Relation of severity and disability. Clin Orthop Relat Res. 1974;101:201-15.
  15. Clanton TO, Schon LC. Athletic injuries to the soft tissues of the foot and ankle. In: Coughlin MJ, Mann RA, editors. Surgery of the foot and ankle. 7th ed. St. Louis: Mosby; 1999. p.1114-203.
  16. Chan KW, Ding BC, Mroczek KJ. Acute and chronic lateral ankle instability in the athlete. Bull NYU Hosp Jt Dis. 2011;69:17-26.
  17. Kerkhoffs GM, Rowe BH, Assendelft WJ, Kelly KD, Struijs PA, van Dijk CN. Immobilisation for acute ankle sprain. A systematic review. Arch Orthop Trauma Surg. 2001;121:462-71. https://doi.org/10.1007/s004020100283
  18. Smith RW, Reischl S. The influence of dorsiflexion in the treatment of severe ankle sprains: an anatomical study. Foot Ankle. 1988;9:28-33. https://doi.org/10.1177/107110078800900106
  19. Polzer H, Kanz KG, Prall WC, Haasters F, Ockert B, Mutschler W, et al. Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm. Orthop Rev (Pavia). 2012;4:e5.
  20. Mehallo CJ, Drezner JA, Bytomski JR. Practical management: nonsteroidal antiinflammatory drug (NSAID) use in athletic injuries. Clin J Sport Med. 2006;16:170-4. https://doi.org/10.1097/00042752-200603000-00015
  21. van den Bekerom MP, Sjer A, Somford MP, Bulstra GH, Struijs PAA, Kerkhoffs GMMJ. Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events. Knee Surg Sports Traumatol Arthrosc. 2015;23:2390-9. https://doi.org/10.1007/s00167-014-2851-6
  22. Petersen W, Rembitzki IV, Koppenburg AG, Ellerman A, Liebau C, Bruggemann GP, et al. Treatment of acute ankle ligament injuries: a systematic review. Arch Orthop Trauma Surg. 2013;133:1129-41. https://doi.org/10.1007/s00402-013-1742-5
  23. Kerkhoffs GM, van den Bekerom M, Elders LA, van Beek PA, Hullegie WA, Bloemers GM, et al. Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline. Br J Sports Med. 2012;46:854-60. https://doi.org/10.1136/bjsports-2011-090490
  24. Al-Mohrej OA, Al-Kenani NS. Acute ankle sprain: conservative or surgical approach? EFORT Open Rev. 2016;1:34-44. https://doi.org/10.1302/2058-5241.1.000010
  25. Seah R, Mani-Babu S. Managing ankle sprains in primary care: what is best practice? A systematic review of the last 10 years of evidence. Br Med Bull. 2011;97:105-35. https://doi.org/10.1093/bmb/ldq028
  26. Kerkhoffs GM, Rowe BH, Assendelft WJ, Kelly K, Struijs PA, van Dijk CN. Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults. Cochrane Database Syst Rev. 2002;(3):CD003762.
  27. Kerkhoffs GM, Struijs PA, Marti RK, Assendelft WJ, Blankevoort L, van Dijk CN. Different functional treatment strategies for acute lateral ankle ligament injuries in adults. Cochrane Database Syst Rev. 2002;(3):CD002938.
  28. Kemler E, van de Port I, Backx F, van Dijk CN. A systematic review on the treatment of acute ankle sprain: brace versus other functional treatment types. Sports Med. 2011;41:185-97. https://doi.org/10.2165/11584370-000000000-00000
  29. Feger MA, Glaviano NR, Donovan L, Hart JM, Saliba SA, Park JS, et al. Current trends in the management of lateral ankle sprain in the United States. Clin J Sport Med. 2017;27:145-52. https://doi.org/10.1097/JSM.0000000000000321
  30. Jones MH, Amendola AS. Acute treatment of inversion ankle sprains: immobilization versus functional treatment. Clin Orthop Relat Res. 2007;455:169-72. https://doi.org/10.1097/BLO.0b013e31802f5468
  31. Hubbard TJ, Aronson SL, Denegar CR. Does cryotherapy hasten return to participation? A systematic review. J Athl Train. 2004;39:88-94.
  32. Bleakley CM, McDonough SM, MacAuley DC, Bjordal J. Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols. Br J Sports Med. 2006;40:700-5; discussion 705. https://doi.org/10.1136/bjsm.2006.025932
  33. van den Bekerom MP, Struijs PA, Blankevoort L, Welling L, van Dijk CN, Kerkhoffs GM. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults? J Athl Train. 2012;47:435-43. https://doi.org/10.4085/1062-6050-47.4.14
  34. Hubbard TJ, Denegar CR. Does cryotherapy improve outcomes with soft tissue injury? J Athl Train. 2004;39:278-9.
  35. Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Am J Sports Med. 2004;32:251-61. https://doi.org/10.1177/0363546503260757
  36. Boyce SH, Quigley MA, Campbell S. Management of ankle sprains: a randomised controlled trial of the treatment of inversion injuries using an elastic support bandage or an Aircast ankle brace. Br J Sports Med. 2005;39:91-6. https://doi.org/10.1136/bjsm.2003.009233
  37. Beynnon BD, Renstrom PA, Haugh L, Uh BS, Barker H. A prospective, randomized clinical investigation of the treatment of first-time ankle sprains. Am J Sports Med. 2006;34:1401-12. https://doi.org/10.1177/0363546506288676
  38. Gwak HC, Seo SS, Kim CW. Nonoperative management of foot and ankle injury related to sports. J Korean Orthop Sports Med. 2004;3:118-27.
  39. Tully MA, Bleakley CM, O'Connor SR, McDonough SM. Functional management of ankle sprains: what volume and intensity of walking is undertaken in the first week postinjury. Br J Sports Med. 2012;46:877-82. https://doi.org/10.1136/bjsports-2011-090692
  40. Specchiulli F, Cofano RE. A comparison of surgical and conservative treatment in ankle ligament tears. Orthopedics. 2001;24:686-8.
  41. van den Bekerom MP, van der Windt DA, Ter Riet G, van der Heijden GJ, Bouter LM. Therapeutic ultrasound for acute ankle sprains. Cochrane Database Syst Rev. 2011;(6):CD001250.
  42. Bennett M, Best TM, Babul S, Taunton J, Lepawsky M. Hyperbaric oxygen therapy for delayed onset muscle soreness and closed soft tissue injury. Cochrane Database Syst Rev. 2005;(4):CD004713.
  43. Kannus P, Renstrom P. Treatment for acute tears of the lateral ligaments of the ankle. Operation, cast, or early controlled mobilization. J Bone Joint Surg Am. 1991;73:305-12. https://doi.org/10.2106/00004623-199173020-00021
  44. Pihlajamaki H, Hietaniemi K, Paavola M, Visuri T, Mattila VM. Surgical versus functional treatment for acute ruptures of the lateral ligament complex of the ankle in young men: a randomized controlled trial. J Bone Joint Surg Am. 2010;92:2367-74. https://doi.org/10.2106/JBJS.I.01176
  45. Pijnenburg AC, Bogaard K, Krips R, Marti RK, Bossuyt PM, van Dijk CN. Operative and functional treatment of rupture of the lateral ligament of the ankle. A randomised, prospective trial. J Bone Joint Surg Br. 2003;85:525-30.
  46. Pijnenburg AC, van Dijk CN, Bossuyt PM, Marti RK. Treatment of ruptures of the lateral ankle ligaments: a meta-analysis. J Bone Joint Surg Am. 2000;82:761-73. https://doi.org/10.2106/00004623-200006000-00002
  47. Povacz P, Unger SF, Miller WK, Tockner R, Resch H. A randomized, prospective study of operative and non-operative treatment of injuries of the fibular collateral ligaments of the ankle. J Bone Joint Surg Am. 1998;80:345-51.
  48. Takao M, Miyamoto W, Matsui K, Sasahara J, Matsushita T. Functional treatment after surgical repair for acute lateral ligament disruption of the ankle in athletes. Am J Sports Med. 2012;40:447-51. https://doi.org/10.1177/0363546511428581
  49. White WJ, McCollum GA, Calder JD. Return to sport following acute lateral ligament repair of the ankle in professional athletes. Knee Surg Sports Traumatol Arthrosc. 2016;24:1124-9. https://doi.org/10.1007/s00167-015-3815-1
  50. Chaudhry H, Simunovic N, Petrisor B. Cochrane in $CORR^{(R)}$: surgical versus conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults (review). Clin Orthop Relat Res. 2015;473:17-22. https://doi.org/10.1007/s11999-014-4018-7
  51. Kobayashi T, Gamada K. Lateral ankle sprain and chronic ankle instability: a critical review. Foot Ankle Spec. 2014;7:298-326. https://doi.org/10.1177/1938640014539813
  52. Frey C, Feder KS, Sleight J. Prophylactic ankle brace use in high school volleyball players: a prospective study. Foot Ankle Int. 2010;31:296-300. https://doi.org/10.3113/FAI.2010.0296
  53. Bahr R, Bahr IA. Incidence of acute volleyball injuries: a prospective cohort study of injury mechanisms and risk factors. Scand J Med Sci Sports. 1997;7:166-71.
  54. Milgrom C, Shlamkovitch N, Finestone A, Eldad A, Laor A, Danon YL, et al. Risk factors for lateral ankle sprains: a prospective study among military recruits. Foot Ankle. 1991;12:26-30. https://doi.org/10.1177/107110079101200105
  55. Verhagen EA, van Mechelen W, de Vente W. The effect of preventive measures on the incidence of ankle sprains. Clin J Sport Med. 2000;10:291-6. https://doi.org/10.1097/00042752-200010000-00012
  56. Handoll HH, Rowe BH, Quinn KM, de Bie R. Interventions for preventing ankle ligament injuries. Cochrane Database Syst Rev. 2001;(3):CD000018.
  57. McKeon PO, Hertel J. Systematic review of postural control and lateral ankle instability, part II: is balance training clinically effective? J Athl Train. 2008;43:305-15. https://doi.org/10.4085/1062-6050-43.3.305