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Bone bruises associated with acute ankle ligament injury: do they need treatment?

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this systematic review is to analyse the current knowledge, incidence, relevance, and need for treatment of bone bruises associated with acute ankle ligament injury.

Methods

A search was made of PubMed, OVID/Medline, Cochrane databases using the keyword “bone bruises” in combination with “ankle”, “sprain”, “management”, “surgery”, and “conservative treatment”.

Results

No randomized controlled trials or prospective cohort studies were found. Only case series were retrieved. A critical appraisal for validity and usefulness of the studies revealed that the best level of evidence on this topic is represented by retrospective comparative studies. Nine studies evaluating the management of bone bruises associated with acute ankle ligament injuries were found.

Conclusion

The clinical prognosis of bone bruises is generally good, with a normalization of MRI appearance usually within 6–12 months after trauma. Currently, there is no evidence that these lesions need specific treatment. Thus, the management of the concomitant ligament lesions is sufficient. Further research is necessary to successfully address the management of bone bruises, and more evidence is required to decide if these lesions need to be treated at all.

Level of evidence

IV.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128, Trigoria, Rome, Italy

    Umile Giuseppe Longo, Mattia Loppini, Giovanni Romeo & Vincenzo Denaro

  2. Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE, Amsterdam, The Netherlands

    C. Niek van Dijk

  3. Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, UK

    Nicola Maffulli

Authors
  1. Umile Giuseppe Longo
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  2. Mattia Loppini
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  3. Giovanni Romeo
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  4. C. Niek van Dijk
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  5. Nicola Maffulli
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  6. Vincenzo Denaro
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Correspondence to Umile Giuseppe Longo.

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Longo, U.G., Loppini, M., Romeo, G. et al. Bone bruises associated with acute ankle ligament injury: do they need treatment?. Knee Surg Sports Traumatol Arthrosc 21, 1261–1268 (2013). https://doi.org/10.1007/s00167-013-2383-5

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  • DOI: https://doi.org/10.1007/s00167-013-2383-5

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