Long-term prognosis of acute lateral ankle ligamentous sprains: high incidence of recurrences and residual symptoms.

BACKGROUND Acute lateral ankle ligamentous sprains (ALALS) are common injuries. This injury does not always have a favourable long-term outcome. Studies reporting the prognosis of ALALS after functional treatment are scarce. OBJECTIVE To determine the prognosis of functionally treated ALALS, in terms of recurrent ALALS and residual symptoms. STUDY DESIGN Retrospective cohort study. SETTING Patients were recruited from 20 family practices, nine physical therapy practices, the emergency departments of a regional hospital and a university hospital. PATIENTS Adult patients with an ALALS caused by an inversion trauma were invited to participate in this study 2.5-5 years after their initial injury. INDEPENDENT VARIABLES Functional treatment of the initial ALALS. MAIN OUTCOME MEASURES Acute lateral ankle ligamentous sprain recurrences and residual symptoms. RESULTS A total of 44 patients were included, with an average follow-up period after the initial ankle sprain of 204 weeks (range 150-274 weeks). Eight patients (18.1%) had reinjured their ankle. Explicit pain around the ankle joint at physical examination was experienced by 45.5%. Clinical symptoms of anterior ankle impingement were present in 25% (all athletes), with radiologically confirmed tibiotalar osteophyte bone formation in 82% of them. CONCLUSIONS A large proportion of patients with ALALS experience recurrences and persistent symptoms after their initial ankle injury. The high percentage of patients with anterior ankle impingement syndromes illustrates the need for early assessment of this impairment in patients with persistent complaints.