AT Study Highlights Success of Nonoperative Approach for High Ankle Sprains

A recent long-term study conducted by Eric D. Nussbaum, MEd, LAT, ATC, an Athletic Trainer at University Orthopaedic Associates in Somerset, New Jersey, along with colleagues from Rutgers University, has provided valuable insights into the effectiveness of nonoperative treatment for high ankle sprains without diastasis.

The case study followed 31 patients, including 24 collegiate athletes and 7 high school athletes, who were treated for 33 high ankle sprains using a nonoperative approach. The patients were tracked for a minimum follow-up of 18 years, offering a comprehensive look at the long-term outcomes.

The treatment protocol included four days of immobilization in a neutral position with a posterior splint, followed by progression to weight-bearing as tolerated, range of motion exercises, and strengthening. The mean age of the patients at follow-up was 45 years, with a mean time from injury to follow-up of 25 years.

According to the study, 42% of patients reported an ipsilateral ankle injury after their initial sprain, while 16% underwent ankle or Achilles surgery. Despite the presence of osteoarthritis (OA) in 27% of the patients, most cases were not clinically significant. The study reported a mean Patient-Reported Outcomes Measurement Information System-10 (PROMIS-10) score of 53.4 and a mean self-reported foot and ankle score of 42.7.

“Our data indicate that nonoperative management of high ankle sprains without diastasis can result in acceptable long-term functional outcomes, with a low rate of subsequent ankle injuries. While we observed a high incidence of osteoarthritis, most cases were not clinically significant.”

The study concluded that these results could serve as a benchmark for comparing newer and more aggressive treatment approaches for high ankle sprains.

“These data will serve as a comparison when assessing the longer-term outcomes of newer and more aggressive treatment regimens."

Read the full study here!