Acute Ankle Sprains in Primary Care

Of all injuries of the musculoskeletal system, 25% are acute lateral ankle sprains.1 In the USA and the UK there are about 23,000 and 5000 ankle sprains, respectively, each day. In the Netherlands approximately 600,000 people sustain an ankle injury each year, of those 120,000 occur during sport, of which 43,000 seek for medical care. The latest statistics in the Netherlands show that general practitioners (GPs) see around 125,000 patients with an ankle sprain each year, with an incidence of eight per thousand patients per year. In the Netherlands, currently there are three clinical guidelines which deal with the diagnosis and treatment of acute lateral ankle injuries. These guidelines roughly correspond with each other and recommend conventional treatment as the primary treatment modality of choice. Conventional treatment consists of early mobilizing, early weight bearing (as much as the pain will allow) combined with (or without) the use of an external support, e.g. tape, brace or bandage. Acute lateral ankle ligaments injuries are treated in various ways. However, before being able to evaluate the eff ectiveness of therapeutic interventions, we need insight into the course of recovery after an acute lateral ankle injury. Benefi cial eff ects or complications of diff erent treatments may be considered against the background of this clinical course. In addition, the identifi cation of relevant subgroups of patients with better or worse prognosis is also important. This may guide management decisions, give directions for future research, and is helpful when informing patients about the clinical course of their injury. Therefore, we performed a systematic review to provide an overview of the literature evaluating the clinical course of conventionally treated acute lateral ankle sprains in adults, and possible prognostic factors for incomplete recovery of this injury.

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