Diagnosis and Treatment of Acute Ankle Sprain

Chu-Hwan Byun; Jin-Wha Chung

doi:10.14193/jkfas.2015.19.3.81

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Byun and Chung: Diagnosis and Treatment of Acute Ankle Sprain

Review Article

J Korean Foot Ankle Soc 2015;19(3):81-85.

Published online: 10 September 2015

DOI: https://doi.org/10.14193/jkfas.2015.19.3.81

Diagnosis and Treatment of Acute Ankle Sprain

Chu-Hwan Byun, Jin-Wha Chung

Department of Orthopedic Surgery, Bucheon St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Bucheon, Korea

Corresponding Author: Jin-Wha Chung Department of Orthopedic Surgery, Bucheon St. Mary's Hospital, 327 Sosa-ro, Wonmi-gu, Bucheon 14647, Korea Tel: 82-32-340-7035, Fax: 82-32-340-2341, E-mail: koreafoot@gmail.com

Received 23 June 2015 Revised 12 July 2015 Accepted 24 July 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Ankle, Sprain, Strain, Functional treatment, Proprioception

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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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