Cover Image

Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm

Hans Polzer, Karl Georg Kanz, Wolf Christian Prall, Florian Haasters, Ben Ockert, Wolf Mutschler, Stefan Grote
  • Hans Polzer
    Munich University Hospital, Department of Trauma Surgery - Innenstadt Campus, Ludwig-Maximilians-University, Munich, Germany | Hans.Polzer@med.uni-muenchen.de
  • Karl Georg Kanz
    Munich University Hospital, Department of Trauma Surgery - Innenstadt Campus, Ludwig-Maximilians-University, Munich, Germany
  • Wolf Christian Prall
    Munich University Hospital, Department of Trauma Surgery - Innenstadt Campus, Ludwig-Maximilians-University, Munich, Germany
  • Florian Haasters
    Munich University Hospital, Department of Trauma Surgery - Innenstadt Campus, Ludwig-Maximilians-University, Munich, Germany
  • Ben Ockert
    Munich University Hospital, Department of Trauma Surgery - Innenstadt Campus, Ludwig-Maximilians-University, Munich, Germany
  • Wolf Mutschler
    Munich University Hospital, Department of Trauma Surgery - Innenstadt Campus, Ludwig-Maximilians-University, Munich, Germany
  • Stefan Grote
    Munich University Hospital, Department of Trauma Surgery - Innenstadt Campus, Ludwig-Maximilians-University, Munich, Germany

Abstract

Acute ankle injuries are among the most common injuries in emergency departments. However, there are still no standardized examination procedures or evidence-based treatment. Therefore, the aim of this study was to systematically search the current literature, classify the evidence, and develop an algorithm for the diagnosis and treatment of acute ankle injuries. We systematically searched PubMed and the Cochrane Database for randomized controlled trials, meta-analyses, systematic reviews or, if applicable, observational studies and classified them according to their level of evidence. According to the currently available literature, the following recommendations have been formulated: i) the Ottawa Ankle/Foot Rule should be applied in order to rule out fractures; ii) physical examination is sufficient for diagnosing injuries to the lateral ligament complex; iii) classification into stable and unstable injuries is applicable and of clinical importance; iv) the squeeze-, crossed leg- and external rotation test are indicative for injuries of the syndesmosis; v) magnetic resonance imaging is recommended to verify injuries of the syndesmosis; vi) stable ankle sprains have a good prognosis while for unstable ankle sprains, conservative treatment is at least as effective as operative treatment without the related possible complications; vii) early functional treatment leads to the fastest recovery and the least rate of reinjury; viii) supervised rehabilitation reduces residual symptoms and re-injuries. Taken these recommendations into account, we present an applicable and evidence-based, step by step, decision pathway for the diagnosis and treatment of acute ankle injuries, which can be implemented in any emergency department or doctor’s practice. It provides quality assurance for the patient and promotes confidence in the attending physician

Keywords

Ankle injury, Ankle sprain, Evidence based algorithm, Diagnosis, Treatment

Full Text:

PDF
HTML
Submitted: 2011-10-04 19:50:41
Published: 2011-12-14 18:07:29
Search for citations in Google Scholar
Related articles: Google Scholar
Abstract views:
5239

Views:
PDF
1537
HTML
1681

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


Copyright (c) 2011 Hans Polzer, Karl Georg Kanz, Wolf Christian Prall, Florian Haasters, Ben Ockert, Wolf Mutschler, Stefan Grote

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
 
© PAGEPress 2008-2018     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185     •     Privacy