Summary

The body adapts to a safe ankle-foot position during the gait cycle, and the timing of these adaptive mechanisms varies to maintain a stable position of the ankle and prevent any potential injury.

Abstract

Introduction

Ankle sprains are among the most prevalent musculoskeletal injuries, often resulting in altered gait mechanics that can significantly affect a patient’s mobility and quality of life. Understanding the impact of different management strategies on gait characteristics is crucial for optimising treatment approaches. Analysis of foot and ankle motion is vital for developing effective treatment strategies. Advanced gait analysis provides valuable insights that help to understand the effects of both conservative and surgical treatments for ATFL injuries.

Objective

This study aimed to analyse and compare the gait characteristics of patients with anterior talofibular ligament (ATFL) injuries managed surgically versus conservatively.

Design:

Prospective cohort study.

Method

In this pilot study, 20 patients were divided equally into conservative and surgical intervention groups. The surgical group comprised patients with grade 3 ATFL tears, while the conservative group included patients with varying degrees of ATFL injury. Gait parameters—including temporal and spatial variables, ankle and foot kinematics, and ankle power—were assessed pre-intervention and six months post-intervention using a motion capture system and force plates with the Shriners Hospital for Children Greenville (SHCG) Foot Model in a 3D gait lab. Statistical analyses were performed using the Wilcoxon-Mann-Whitney U test, Kruskal-Wallis test, and Friedman test with the help of SPSS v.26.0.

Results

All gait analysis parameters were comparable between the conservative and surgical groups at six months, except for two parameters. The timing of maximum dorsiflexion during the stance phase was significantly delayed in the surgical group (47.89%) compared to the conservative group (41.44%), demonstrating an alteration in gait mechanics (p = 0.024). Similarly, the timing of maximum plantarflexion during the swing phase occurred later in the surgical group (65.56%) than in the conservative group (63.00%), further indicating that surgical management impacts the timing of key movements during gait (p = 0.044).

Conclusion

Both conservative and surgical interventions are viable options for managing ATFL injuries, yielding comparable gait parameters at six months. However, the timing of key gait adaptations varies, indicating different proprioceptive responses depending on the treatment type. The body adapts to a safe ankle-foot position during the gait cycle, and the timing of these adaptive mechanisms varies to maintain a stable position of the ankle and prevent any potential injury.