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Comparative results of conservative treatments for isolated anterior talofibular ligament (ATFL) injury and injury to both the ATFL and calcaneofibular ligament of the ankle as assessed by subtalar arthrography

  • Original article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

There have been no reports describing the results of conservative treatment of acute lateral ligament injury of the ankle in detail in terms of the severity of the injury, and the results of conservative treatment for injury with severe instability are still controversial. The purpose of this study was to assess the results of nonoperative treatment of acute lateral ligament injury according to its severity.

Methods

Fifty-five consecutive acute lateral ankle ligament injuries in 54 patients who were treated nonoperatively were followed up as a prospective study. Twenty-seven were male patients and 27 were female patients; the average age was 23.9 years (12–55 years). The patients were divided into two groups according to the extent of the ligament injury: patients with an isolated injury of the anterior talofibular ligament and those with combined injuries of the anterior talofibular ligament and the calcaneofibular ligament. In addition to the routine examinations for inversion ankle sprain, subtalar arthrography was mainly used to assess the condition of the calcaneofibular ligament. The arthrography was performed an average of 3.5 days after the injury (0–5 days).

Results

Fifty-five ankles of patients who were treated nonoperatively according to the same protocol were included in this study, and were followed up for an average of 5.0 years (37–86 months). At the time of the final follow-up, 22 of 25 (88%) ankles with an isolated injury to the anterior talofibular ligament were asymptomatic; in contrast, only 9 of 30 (30%) ankles with combined injuries of the anterior talofibular and calcaneofibular ligament were asymptomatic. The average American Orthopaedic Foot and Ankle Society score of the isolated injuries was 97.8 points, in contrast to 92.4 points for the combined injuries.

Conclusions

The results of nonoperative treatment with 1 week immobilization followed by a functional brace were excellent in patients with an isolated injury of the anterior talofibular ligament, but were unsatisfactory in those with combined injuries of the anterior talofibular and calcaneofibular ligaments.

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References

  1. A Kaikkonen P Kannus M Järvinen (1996) ArticleTitleSurgery versus functional treatment in ankle ligament tears: prospective study Clin Orthop 326 194–202 10.1097/00003086-199605000-00023 Occurrence Handle10.1097/00003086-199605000-00023 Occurrence Handle8620641

    Article  PubMed  Google Scholar 

  2. HB Kitaoka MD Lee BF Morrey JR Cass (1997) ArticleTitleAcute repair and delayed reconstruction for lateral ankle instability: twenty-year follow-up study J Orthop Trauma 11 530–5 10.1097/00005131-199710000-00012 Occurrence Handle10.1097/00005131-199710000-00012 Occurrence Handle1:STN:280:DyaK2svnsFCntg%3D%3D Occurrence Handle9334956

    Article  CAS  PubMed  Google Scholar 

  3. B Niedermann A Anderson SB Anderson V Funder JP Jørgensen E Lindholmer et al. (1981) ArticleTitleRupture of the lateral ligaments of the ankle: operation or plaster cast? A prospective study Acta Orthop Scand 52 579–87 Occurrence Handle1:STN:280:DyaL387jtF2qtg%3D%3D Occurrence Handle6800213 Occurrence Handle10.3109/17453678108992150

    Article  CAS  PubMed  Google Scholar 

  4. P Povacz F Ungers WK Miller R Tockner H Resch (1998) ArticleTitleA randomized, prospective study of operative and non-operative treatment of injuries of the fibular collateral ligaments of the ankle J Bone Joint Surg Am 80 345–51 10.1302/0301-620X.80B2.8032 Occurrence Handle10.1302/0301-620X.80B2.8032 Occurrence Handle1:STN:280:DyaK1c7ovFKrtQ%3D%3D Occurrence Handle9531201

    Article  CAS  PubMed  Google Scholar 

  5. SA Lynch PAFH Renstrom (1999) ArticleTitleTreatment of acute lateral ankle ligament rupture in the athlete Sports Med 27 61–71 10.2165/00007256-199927010-00005 Occurrence Handle10.2165/00007256-199927010-00005 Occurrence Handle1:STN:280:DyaK1M7lt1Cmuw%3D%3D Occurrence Handle10028133

    Article  CAS  PubMed  Google Scholar 

  6. ACM Pijnenburg CN Van Dijk PMM Bossuyt RK Marti (2000) ArticleTitleTreatment of ruptures of the lateral ankle ligaments: a meta-analysis J Bone Joint Surg Am 82 761–73 Occurrence Handle1:STN:280:DC%2BD3czhsFKhtQ%3D%3D Occurrence Handle10859095

    CAS  PubMed  Google Scholar 

  7. K Sugimoto N Samoto T Takaoka Y Takakura S Tamai (1998) ArticleTitleSubtalar arthrography in acute injuries of the calcaneofibular ligament J Bone Joint Surg Br 80 785–90 10.1302/0301-620X.80B5.7921 Occurrence Handle10.1302/0301-620X.80B5.7921 Occurrence Handle1:STN:280:DyaK1cvjvFyhsQ%3D%3D Occurrence Handle9768887

    Article  CAS  PubMed  Google Scholar 

  8. CN Van Dijk LS Lim PM Bossuyt RK Marti (1996) ArticleTitlePhysical examination is sufficient for the diagnosis of sprained ankles J Bone Joint Surg Br 78-B 958–62 10.1302/0301-620X78B6.1283 Occurrence Handle10.1302/0301-620X78B6.1283

    Article  Google Scholar 

  9. O Landeros HM Frost CC Higgins (1968) ArticleTitlePost-traumatic anterior ankle instability Clin Orthop 56 169–78 Occurrence Handle1:STN:280:DyaF1c3nt1ektw%3D%3D Occurrence Handle5652775

    CAS  PubMed  Google Scholar 

  10. W Taillard JM Meyer J Gracia Y Blanc (1981) ArticleTitleThe sinus tarsi syndrome Int Orthop 5 117–30 10.1007/BF00267842 Occurrence Handle10.1007/BF00267842 Occurrence Handle1:STN:280:DyaL38%2Fgs1Khtg%3D%3D Occurrence Handle7275413

    Article  CAS  PubMed  Google Scholar 

  11. HB Kitaoka IJ Alexander RS Adelaar JA Nunley MS Myerson M Sanders (1994) ArticleTitleClinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes Foot Ankle Int 15 349–53 Occurrence Handle1:STN:280:DyaK2M%2FjvFKlug%3D%3D Occurrence Handle7951968

    CAS  PubMed  Google Scholar 

  12. P Kannus P Renström (1991) ArticleTitleTreatment for acute tears of the lateral ligaments of the ankle. Operation, cast, or early controlled mobilization J Bone Joint Surg Am 73 305–12 Occurrence Handle1:STN:280:DyaK3M7jtFKktQ%3D%3D Occurrence Handle1993726

    CAS  PubMed  Google Scholar 

  13. Y Tochigi K Takahashi M Yamagata T Tamaki (2000) ArticleTitleInfluence of the interosseous talocalcaneal ligament injury on stability of the ankle-subtalar joint complex — a cadaveric experimental study Foot Ankle Int 21 486–91 Occurrence Handle1:STN:280:DC%2BD3cvntVWgtA%3D%3D Occurrence Handle10884108

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Nara Prefectural Hospital, 1-30-1 Hiramatsu, Nara, Nara, 631-0846, Japan

    Norihiro Samoto

  2. Department of Orthopaedic Surgery, Saiseikai Nara Hospital, Nara, Japan

    Kazuya Sugimoto

  3. Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan

    Takanori Takaoka, Tadashi Fujita & Yoshinori Takakura

  4. Higashiosaka City General Hospital, Osaka, Japan

    Chikara Kitada

Authors
  1. Norihiro Samoto
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  2. Kazuya Sugimoto
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  3. Takanori Takaoka
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  4. Tadashi Fujita
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  5. Chikara Kitada
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  6. Yoshinori Takakura
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Samoto, N., Sugimoto, K., Takaoka, T. et al. Comparative results of conservative treatments for isolated anterior talofibular ligament (ATFL) injury and injury to both the ATFL and calcaneofibular ligament of the ankle as assessed by subtalar arthrography. J Orthop Sci 12, 49–54 (2007). https://doi.org/10.1007/s00776-006-1090-1

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  • DOI: https://doi.org/10.1007/s00776-006-1090-1

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