Ultasound guided management of ankle sprain

Abstract

Background: Ankle sprain accounts for 15-20% of sports injuries. They are complex injuries and studies that better delineate the etiology are needed. The accuracy of ultrasound as a diagnostic modality of ankle sprain is comparable to MRI. In this study we evaluated the use of ultrasound in delineating the grade of sprain, with special emphasis of grade 2 sprains. Methods: We prospectively studied 80 ankle sprains of over two years. All the patients with features of ankle sprain were evaluated with high frequency ultrasound. Grade 1 & 2 sprains were included in the study. All the patients were followed up for 1 year. Grade 2 sprains were treated with cast for 6 weeks and evaluated for any residual symptoms and chronicity. Results: There were 51 males and 29 females with right ankle injured in 57 patients. Seventy-three patients were injured during their leisure activities and 7 were sports injuries. According to ultrasound grading, there were 58 grade 1 injuries, 22 being grade 2 sprain. All the patients were followed up till 1 year. At the end of one year, 79 patients were recovered well with no residual symptoms. Conclusions: Ultrasonogram effectively differentiates grade 1 from grade 2 and gives a clue for further management. Therefore, we recommend routine use of ultrasonogram for every ankle sprain. For grade 2 sprains, rigid immobilization for 6 weeks gives excellent results with no residual symptoms.