Management of lateral ankle injuries A multidimensional approach

Lateral ankle sprains are the most commonly seen musculoskeletal injury. As such, an increasing number of studies report high numbers of patients that experience posttraumatic ankle instability and limitations in activities of daily living (ADL), work and sports. Based on the findings of the studies included in this thesis treatment first and foremost should consists of functional therapy including rest, ice, compression and elevation, NSAIDs, exercise therapy and brace use. In order to increase effectiveness of treatment and prevention programs, addressing individual risk factors for sustaining recurrent lateral ankle sprains and developing chronic ankle joint instability, such as a high weight, high BMI and stability deficits, is recommended. Risk factors provide opportunity for individualised treatment and prevention strategies and will subsequently help to avoid a cascade of comorbidities, and limitations in ADL and sports.
In case these treatment options prove insufficient in establishing recovery, surgical stabilisation through anatomic reconstruction or anatomic repair may be the treatment of choice.
Regardless the chosen treatment, monitoring through the use of Patient Reported Outcome Measures, such as the Cumberland Ankle Instability Tool, is necessary to define whether a patient experiences recovery or whether adaptation of the treatment strategy is required.
The complexity of a lateral ankle sprain concerns the composition of multiple risk factors and negative prognostic factors. These need to be addressed in prevention programs, in addition to adequate diagnosis of the extent of the injury and individualised treatment from the moment of initial presentation to warrant patient recovery.