Evidence-based treatment choices for acute lateral ankle sprain: a comprehensive systematic review

Review written by Dr Chris Bleakley info

Key Points

  1. Most patients presenting with acute ankle sprain can be managed conservatively (although contemporary surgical techniques have not yet been rigorously examined).
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BACKGROUND & OBJECTIVE

Acute ankle sprains occur frequently, particularly in sports, with an estimated 0.9 per 1000 athletic exposures (1). Currently, most ankle sprains are managed conservatively, based on protected mobilisation combined with therapeutic exercise. Surgical management of ankle sprains is usually reserved for elite level athletes presenting with higher grades of injury.

The primary aim of this systematic review was to compare conservative management vs surgery, after acute ankle sprain. As the nature of conservative treatment can vary, the review’s secondary aims were to determine if there is evidence to inform a). an optimal method of external bracing and b). the key components (content dose) of rehabilitation protocols after ankle sprain.

Surgical management of ankle sprains is usually reserved for elite level athletes presenting with higher grades of injury.
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There is much evidence that impairment based therapeutic exercises are effective after ankle sprain.

METHODS

This systematic review followed PRISMA guidelines and included a comprehensive search of 3 major databases. The authors limited inclusion to randomized controlled trials (RCTs) making any of the following comparisons: surgery vs conservative treatment; different types of external supports; different

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