Introduction
Lateral ankle sprain is one of the commonest musculoskeletal injuries and it is not as innocuous as it was thought to be because it has substantial morbidities such as increased risk of reinjury, development of chronic lateral ankle instability (CLAI) and posttraumatic ankle osteoarthritis. Patients with CLAI had been correlated with multiple associated ankle injuries and poorer outcomes. Hence, we aim to review the prevalence of patients with CLAI and their characteristics in a cohort of patients treated for symptomatic lateral ankle instability.
Materials And Methods
A retrospective review of 231 patients who were sequentially treated surgically for symptomatic lateral ankle instability from 2017 to 2022 was performed. Patient demographics, presence of CLAI, associated injuries and functional scores were analyzed.
Results
These 231 patients were predominantly males (168; 72.7%) with an average age of 30 years (S.D.=11.2) and average body mass index (BMI) of 26.2 (S.D.=5). All of them had associated injuries such as osteochondral lesions (26%), deltoid ligament injuries (39.8%), peroneal tendon injuries (25.1%), syndesmosis injuries (14.3%) and fibula tip avulsion fractures (15.2%). There were 170 (73.6%) patients with CLAI in this study cohort and they were significantly younger than those with single sprain (28.9 years vs 33 years; p=0.006) although they were not significantly different in terms of gender, BMI and associated injuries. Preoperative AOFAS scores (57.2 vs 64.9; p=0.039) and SF-36 Physical Component Score [PCS] (41.7 vs 45.4; p=0.032) were found to be significantly lower in patients with CLAI even though these scores were gradually improved and equalized at 1 year postoperatively.
Conclusion
More than two thirds of patients with symptomatic lateral ankle instability had CLAI and they were found to be younger and had poorer AOFAS and SF-36 PCS scores at presentation when compared to those with single sprain. Despite that, functional scores demonstrated improvement and equalized at 1 year after surgical stabilization. Surgical stabilization for symptomatic lateral ankle instability yielded good outcomes for both patients with CLAI and those with single sprain.