Operative and functional treatment of rupture of the lateral ligament of the ankle. A randomised, prospective trial.
Consecutive patients with a confirmed rupture of at least one of the lateral ligaments of the ankle were randomly assigned to receive either operative or functional treatment. They were evaluated at a median of 8 years (6 to 11). In total, 370 patients were included. Follow-up was available for 317 (86%). Fewer patients allocated to operative treatment reported residual pain compared with those who had been allocated to functional treatment (16% versus 25%, RR 0.64, CI 041 to 1.0). Fewer surgically-treated patients reported symptoms of giving way (20% versus 32%, RR 0.62, CI 0.42 to 0.92) and recurrent sprains (22% versus 34%, RR 0.66, CI 0.45 to 0.94). The anterior drawer test was less frequently positive in surgically-treated patients (30% versus 54%, RR 0.54, CI 0.41 to 0.72). The median Povacz score was significantly higher in the operative group (26 versus 22, p < 0.001). Compared with functional treatment, operative treatment gives a better long-term outcome in terms of residual pain, recurrent sprains and stability.
Pijnenburg
A C M
AC
Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, The Netherlands.
Bogaard
K
K
Krips
R
R
Marti
R K
RK
Bossuyt
P M M
PM
van Dijk
C N
CN
D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000150:complications / Q000601:surgery / Q000628:therapy*; D001458:Bandages; D002370:Casts, Surgical; D017885:Collateral Ligaments / Q000293:injuries* / Q000601:surgery; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D012008:Recurrence; D012421:Rupture / Q000150:complications / Q000601:surgery / Q000628:therapy; D013180:Sprains and Strains / Q000209:etiology; D016896:Treatment Outcome