Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm

• DOI: 10.4081/or.2012.e5
• Publication Date: 2012-02-07T14:03:39Z
• Authors: Hans Polzer; Karl Georg Kanz; Wolf Christian Prall; Florian Haasters; Ben Ockert; W. Mutschler; Stefan Grote
• Keywords: Syndesmosis; Evidence-Based Medicine

Acute ankle injuries are among the most common in emergency departments. However, there still no standardized examination procedures or evidence-based treatment. Therefore, aim of this study was to systematically search current literature, classify evidence, and develop an algorithm for diagnosis treatment acute injuries. We searched PubMed Cochrane Database randomized controlled trials, meta-analyses, systematic reviews or, if applicable, observational studies classified them according their level evidence. According currently available following recommendations have been formulated: i) Ottawa Ankle/Foot Rule should be applied order rule out fractures; ii) physical is sufficient diagnosing lateral ligament complex; iii) classification into stable unstable applicable clinical importance; iv) squeeze-, crossed leg- external rotation test indicative syndesmosis; v) magnetic resonance imaging recommended verify vi) sprains a good prognosis while sprains, conservative at least as effective operative without related possible complications; vii) early functional leads fastest recovery rate reinjury; viii) supervised rehabilitation reduces residual symptoms re-injuries. Taken these account, we present evidence-based, step by step, decision pathway injuries, which can implemented any department doctor's practice. It provides quality assurance patient promotes confidence attending physician.