Article Text

PDF
3 Course and prognosis of acute lateral ankle sprains in general practice
  1. AKE Mailuhu,
  2. JM van Ochten,
  3. PJE Bindels,
  4. SMA Bierma-Zeinstra,
  5. M van Middelkoop
  1. Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands

Abstract

Background Persistent complaints are very common after a lateral ankle sprain however, prognostic factors are largely unknown.

Objective To examine the five-year prognosis and potential prognostic factors of patients with an acute lateral ankle sprain in general practice (GP).

Design Observational study.

Setting Primary care.

Patients 206 patients who participated in a cross-sectional study and visited their GP with a lateral ankle sprain 6 to 12 months prior to inclusion were approached for a 5-year follow-up measurement consisting of an online questionnaire.

Assessment of risk factors At baseline, all patients received a standardised questionnaire, underwent a physical examination and MRI assessment of their ankle. Potential prognostic factors included patient characteristics (age, gender, BMI), symptoms (pain: NRS/10), Ankle Function Score (AFS/100), perceived recovery (7-point Likert) and structural abnormalities on MRI (bone marrow lesions and cartilage loss).

Main outcome measurements The online follow-up questionnaire assessed perceived recovery (dichotomized in persistent complaints: ‘completely recovered or strongly improved’ and no persistent complaints: ‘slightly improved to worse than ever’), pain at rest and during exercise (NRS/10), AFS and re-sprains.

Results Of the 206 included patients, 132 (64.1%) patients completed the 5-year follow-up questionnaire. Age and pain during exercise at baseline were significantly higher in the responders. After 5-years follow-up, persistent complaints were reported by 18.2% compared to 40.9% at baseline and a re-sprain had occurred in 29.5% of the responders. The mean AFS was 79.9 (26.1). BMI, perceived recovery, AFS and pain at rest and during exercise at baseline were univariate significantly associated with persistent symptoms at 5-year follow-up. None of the variables were significantly associated with persistent complaints in the multivariable model.

Conclusions Almost 20% of patients who visited their GP with a lateral ankle sprain experience persistent complaints after 5 years follow-up. No prognostic factors could be determined for these persistent complaints.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.