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24 Impact of a lateral ankle sprain in general practice: comparison between patients with and without persistent complaints after  6–12 months
  1. JM van Ochten,
  2. S Bierma-Zeinstra,
  3. PJE Bindels,
  4. M van Middelkoop
  1. Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands

Abstract

Background Although ankle sprains are common and often lead to persistent complaints, their impact on functioning and related costs remains unclear.

Objective To investigate the impact of a lateral ankle sprain  on functioning and medical consumption after 6–12 months follow-up.

Design Cross-sectional study.

Setting General practice.

Patients Of the 204 included patients who visited their general practitioner 6–12 months after a lateral ankle sprain, 96 reported persistent complaints (PC) and 108 reported no persistent complaints (NPC). A 7-points Likert scale divided patients into NPC (a 1–2 score, completely recovered or strongly improved) and PC (a score of 3–7, slightly improved to worse than ever).

Assessment of risk factors A standardised questionnaire included the 7-point Likert scale to measure recovery.

Main outcome measurements A questionnaire assessed age, gender and BMI, history of sprain, pain in rest and during exercise on a Numeric Rating Scale (NRS, 0–10), function using the Ankle Function Score (AFS, 0–100), Tegner score (11-points activity score), Foot and Ankle Disability Index (0–34 points score) and complaints in work and physical activity (NRS;  0–10).

Results A significantly higher BMI (26.9 and 24.9 kg/m2), higher pain scores at rest (1.87 vs 0.44) and during exercise (3.62 vs 1.25) and a lower AFS (72.47 vs 82.90) were reported in the group with PC, while a higher percentage of patients in the NPC group participated in sports (77.8% vs 36.4%). A high medical consumption (76.5% visiting the GP, 20.1% a medical specialist and 45.6% a physiotherapist) and radiographic imaging (35.3%) were reported in both study groups.

Conclusions A lateral ankle sprain has a high impact on functioning and physical health, especially in those with persistent complaints. In patients with and without persistent complaints, considerable consumption of medical resources was found 6–12 months after the initial visit to the general practitioner.

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