Abstract
Acute ankle sprains are one of the most common musculoskeletal injuries evaluated and treated by primary care physicians. Ankle sprains are common in adolescents and young adults and typically occur during athletic activity. Risk factors include a previous ankle sprain and body mass index greater than 25. There are 3 common types of ankle ligamentous injuries: lateral ankle, deltoid, and syndesmotic ligamentous injuries, with the lateral ankle sprain being the most common. A thorough history and physical examination including special tests (the anterior drawer, talar tilt, and squeeze or external rotation tests) would aid in the diagnosis of these ankle ligamentous injuries. Furthermore, using the Ottawa foot and ankle rule would help determine the need for diagnostic imaging to supplement the physical examination in making an accurate diagnosis. Once a diagnosis is obtained, appropriate medical treatment can be administered including nonsteroidal antiinflammatory drugs, cryotherapy, osteopathic manipulative medicine, activity modification with external support devices, and physical therapy. In the acute inflammatory phase, an acronym of RICES (rest, ice, compression, elevation, and support) can be used as a basic treatment guide.
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