SLR - February 2012 - Jashan A. Valjee
Reference: Takao M, Miyamoto W, Matsui K, Sasahara J, Matsushita T. Am J Sports Med. Nov 30, 2011 (ePub ahead of print).
Scientific Literature Review
Reviewed by: Jashan A. Valjee, DPM
Residency Program: Detroit Medical Center
Podiatric Relevance:
The aim of this study was to determine if functional treatment of acute ankle sprains after primary surgical repair is more effective than functional treatment alone.
Methods:
132 ankles of 132 patients were used in this study. Two groups were randomly formed: 78 patients solely underwent functional treatment (group F) and 54 patients were had primary surgical repair followed by functional treatment (group RF). The talar tilt angle and the anterior displacement of the talus in stress films were evaluated using the Japanese Society for Surgery of the Foot Ankle-Hindfoot scale (JSSF) score. The elapsed time between the injury and return to full athletic activity were also documented.
Results:
There was not a statistically significant difference between the two groups in the mean JSSF scores 2 years after injury. There were also not statistically significant differences in the talar tilt angle and displacement of the talus on stress films between group F (P = 0.4093) and group RF (P = 0.1883). However, group F showed that 8 cases had poor results with JSSF scores below 80 points and instability at 2 years. Also, the elapsed time between injury and return to full athletic activity was 16.0 ± 5.6 weeks in group F and 10.1 ± 1.8 weeks in group RF.
Conclusions:
Functional treatment alone demonstrated similar overall results as primary surgical repair. However, nonoperative treatment had a 10% failure rate and a slower return to full athletic activity. The authors recommend specifically tailored treatment for each athlete.