Functional Outcome of Conservative Treatment of Isolated Anterior Talofibular Ligament Injury - A Prospective Analysis

Abstract

Introduction: Ligamentous injuries of the ankle are very commonly encountered in orthopaedic practice and 40% of these injuries constitute the Anterior Talo-Fibuar ligament (ATFL) injuries. It is the weakest of the lateral ligaments. Unless there is significant joint instability, surgery is rarely indicated in the treatment of isolated ATFL injuries. Our study focused on the assessment of the long term outcome of isolated ATFL injuries treated by conservatively. Material and Methods: We included 20 patients who presented to us with isolated ATFL injury from January 2015 to march 2015 for this prospective study. The diagnosis was confirmed with an MRI. 12(60%) patients were grade II and 8 (40%) patients were grade III. All the patients were conservatively treated with the POLICE protocol and weight-bearing was advised as tolerated but strictly with a proper ankle support. Patients were followed up at the end of 1st week, 2nd week, 1 month,3rd month and at 6 months. Patients were evaluated with a Visual Analog Scale (VAS) and the Foot and Ankle Outcome score (FAOS). Results: There was statistically significant improvement in the VAS and FAOS scores. From the pre-treatment scores of 9.1 and 53, they improved to 1.4 and 91 respectively at the final follow-up. Conclusion: From our prospective study, we conclude that conservative management of isolated ATFL injuries is a safe and effective method of treatment. Key words: Anterior Talo-Fibular Ligament (ATFL); Lateral ligament Injuries of ankle; Conservative: POLICE