Of all the ankle ligaments present, the most commonly (85 %) involved ligament to be sprained is the Lateral ligament complex (Anterior Talofibular, Posterior Talofibular and Calcaneofibular Ligs.). Based on the severity (stable / unstable) of sprain the protocols are carried out usually. I came across this article and found it quite new that these UNSTABLE ankle sprains can be corrected without SURGERY (based on evidence obtained from more than 1500 articles on the Rx for ankle sprain). So, could the unstable ankle sprains be rehabilitated in a FUNCTIONAL protocol (as this article has proven) ??
The surgical when compared with conservative treatment shows no difference in the results particularly in ROM and stability.(my personal experience)
Functional treatment with a short period of protection and early weight-bearing, followed by physiotherapy is my option in the majority of the patients. I think the surgical treatment may be superior in selected cases , for example, in a person who is skilled in competitive track and field events (athletics)
I agree entirely with Nelson. Surgical repair should be done on emergency base for active young people and active athletes. The other could be treated conservatively.
Clinically I have found that one of the most common obstacles in the rehabilitation of unstable ankle sprains is pathomechanics – more specifically – gravity drive (abnormal) pronation.
Run a video analysis on your patient’s gait. If you observe an abnormal pronation pattern, provide the necessary intervention to attenuate/eliminate it.
Doing this simple, non-invasive intervention will greatly accelerate your patient’s recovery.
http://athletics.wikia.com/wiki/Gravity_Drive_(Abnormal)_Pronation
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