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Emergency Department Evaluation: Ankle Injuries

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Emergency Department Evaluation: Ankle Injuries

Emergency Department Evaluation: Ankle Injuries

The May 2002 issue of Emergency Medicine Practice, "Ankle Injuries In The ED: How To Provide Rapid And Cost- Effective Assessment And Treatment ," features a full discussion of ankle injuries. Key points concerning sportsrelated ankle injuries follow.

Ankle sprains are the most common of all ankle injuries (85% of all acute ankle injuries are sprains86) and are especially likely to be sustained in sports and recreational activities.43 At present, functional treatment is the rule, and less importance is attributed to differentiating between single and multiple ligament injuries.43 The ankle is often injured during football when a player attempts to change direction quickly on an outside leg that is planted during pivoting. A player's ankle may also be injured by being stepped on.

Some controversy exists regarding the optimal treatment of ankle sprains. A recent systematic review of 12 studies of high methodological quality evaluated functional treatment vs. immobilization. The data favor the functional approach (early mobilization as tolerated) for the following outcomes: return to work and sports, short-term resolution of swelling, and intermediate subjective stability. Immobilized patients were more likely to have impaired range of motion. Patients in the functional management group were more likely to be satisfied with their care in the short and intermediate term and tended to report less pain. No differences were noted between subjective stability or rates of recurrent ankle pain.87

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