Journal List > J Korean Foot Ankle Soc > v.19(3) > 1043378

Byun and Chung: Diagnosis and Treatment of Acute Ankle Sprain

Abstract

Acute sprain of the ankle requires comprehensive history taking and physical examination in diagnosing the type of severity and deciding on the plan of treatment. Literature supports functional treatment as the treatment of choice for grade I and II injuries. During the acute phase, the goal of treatment focuses on controlling pain and swelling. PRICE (protection, rest, ice, compression, and elevation) is a well-established protocol at this phase. There is some evidence that application of ice and use of nonsteroidal anti-inflammatory drugs improves healing and speeds recovery. Then the functional treatment (motion restoration and strengthening exercises) is administered to progress the rehabilitation appropriately in order to facilitate healing and restore the mechanical strength and proprioception. Early mobilization has been shown to result in more rapid return to work and daily activities than immobilization. Grade III injuries still generate controversy in terms of the best management available, and more studies on early mobilization, cast immobilization, or surgery are needed. Even the Cochrane reviews published to date are not conclusive.

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Table 1.
Grades of Acute Ankle Sprain
Sign and symptom Grade I Grade II Grade III
Ligament tear Intrasubstance Partial Complete
Pain Mild Moderate Severe
Swelling Mild Moderate Severe
Ecchymosis Usually not Common Yes
Decreased ankle motion Minimal Some Great
Difficulty bearing weight None Usual Always
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