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The role of stress radiographs for the severe ankle sprain: A 7-year prospective study

Abstract

Ankle sprains are common. They are the most common musculoskeletal injury in athletes and account for about 2 million emergency department visits annually in the United States. Although ankle radiographs are often indicated to rule out fractures of the acutely sprained ankle, the need for additional imaging work-up, such as stress radiographs, to evaluate the severity of ligamentous injury is not clear. One hundred five patients with severe ankle sprains diagnosed by stress radiographs were randomized into three conservative modes of therapy (Schantz wrap, cast brace, cast) and followed prospectively for 7 years. There was no statistically significant difference among treatment groups for mechanical outcome at 1 year (P=0.27) or for functional outcome at 5 years (P=0.39) and 7 years (P=0.27) after injury. We conclude that: (a) there currently is no recommendation for stress radiographs in the setting of the acutely sprained ankle, and (b) a larger multicenter study is needed to confirm these findings.

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Correspondence to Kenneth M. Vitellas M.D..

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Vitellas, K.M., Mueller, C.F., Blau, N.A. et al. The role of stress radiographs for the severe ankle sprain: A 7-year prospective study. Emergency Radiology 2, 339–344 (1995). https://doi.org/10.1007/BF02615897

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Key Words

  • Ankle sprain
  • Talar tilt
  • Anterior drawer
  • Stress radiographs