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Pediatric Emergency Care May 2020Ankle injuries are a common reason for presentation to the pediatric emergency department. An understanding of the anatomy of the ankle joint, the mechanism of injury,... (Review)
Review
Ankle injuries are a common reason for presentation to the pediatric emergency department. An understanding of the anatomy of the ankle joint, the mechanism of injury, and a thorough history and physical examination can help narrow the differential diagnosis. This article will discuss the management of common ankle injuries, including ankle sprains, dislocations, and pediatric fractures, including transitional triplane and Tillaux fractures. A brief review of the literature regarding radiographic evaluation of the ankle and various ankle rules is also discussed.
Topics: Ankle Injuries; Ankle Joint; Child; Emergency Service, Hospital; Fibula; Fractures, Bone; Humans; Joint Dislocations; Medical History Taking; Sprains and Strains; Tibial Fractures
PubMed: 32355069
DOI: 10.1097/PEC.0000000000002097 -
PM & R : the Journal of Injury,... Mar 2023Health disparities related to concussions have been reported in the literature for certain minority populations. Given the significant impact of concussions on long- and...
BACKGROUND
Health disparities related to concussions have been reported in the literature for certain minority populations. Given the significant impact of concussions on long- and short-term function, the mitigation of barriers to accessing care is an important public health objective.
OBJECTIVE
To determine if racial and ethnic disparities exist in patients who seek care for concussions compared to a control group with orthopedic ankle injuries (sprains and fractures) to minimize confounding factors that predispose to injury.
DESIGN
Cohort study.
SETTING
Single institution between February 2016 and December 2020.
PATIENTS
A retrospective review of electronic medical records was completed for patients with International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes for concussion, ankle sprain, and ankle fracture. A total of 10,312 patients were identified: 1568 (15.2%) with concussion, 4871 (47.3%) with ankle sprain, and 3863 (37.5%) with ankle fracture.
INTERVENTIONS
Patients were stratified by demographic factors, including sex, ethnicity, race, and insurance type.
MAIN OUTCOME MEASURES
Diagnosis of concussion.
RESULTS
The concussion group was the youngest (28.3 years ± 18.0) and had the fewest females (53.1%) compared to the ankle sprain (35.1 years ± 19.7; 58.7%) and fracture groups (44.1 years ± 21.3; 57.3%). The concussion group had a smaller proportion of Hispanic patients than the ankle sprain group (odds ratio [OR] 0.71, 95% confidence interval [CI] 0.55-0.92, p = .010) and fracture group (OR 0.58, 95% CI 0.44-0.75, p = <.001). In addition, the concussion group was less likely to be Asian (OR 0.70, CI 0.52-0.95, p = .023) than the sprain group and less likely to be Black/African American than both sprain (OR 0.65, 95% CI 0.46-0.93, p = .017) and fracture groups (OR 0.62, 95% CI 0.43-0.89, p = .010). There were no differences across racial groups between ankle sprains and fractures. Patients with Medicaid/Medicare and self-pay had a higher likelihood of being in the concussion group than those with private insurance.
CONCLUSION
Differences in concussion diagnosis may exist between certain demographic groups compared to those with ankle injuries. Efforts to mitigate disparities in concussion care are worthwhile with a focus on patient and caregiver education.
Topics: Female; Humans; Aged; United States; Cohort Studies; Ankle Fractures; Medicare; Brain Concussion; Sprains and Strains; Ankle Injuries; Retrospective Studies; Healthcare Disparities
PubMed: 35191195
DOI: 10.1002/pmrj.12793 -
JAAPA : Official Journal of the... Jan 2022
Topics: Athletic Injuries; Humans; Lower Extremity; Sprains and Strains
PubMed: 34939591
DOI: 10.1097/01.JAA.0000803684.13174.84 -
Foot and Ankle Clinics Jun 2023Lateral ankle sprain (LAS) is not as simple as it was believed to be as it has substantial negative impacts on the active sporting population. The negative impact on... (Review)
Review
Lateral ankle sprain (LAS) is not as simple as it was believed to be as it has substantial negative impacts on the active sporting population. The negative impact on physical function, quality of life (QoL) and economic burden is significant with increased risk of reinjury, development of chronic lateral ankle instability and posttraumatic ankle osteoarthritis resulting in functional deficits, decreased QoL and chronic disabilities. Economic burden from a societal perspective demonstrated notably higher indirect costs from productivity loss. Preventative interventions with early surgery for a selective cohort of active sporting population may be considered to mitigate morbidities associated with LAS.
Topics: Humans; Sprains and Strains; Quality of Life; Joint Instability; Osteoarthritis; Ankle Injuries
PubMed: 37137618
DOI: 10.1016/j.fcl.2022.12.002 -
Clinical Rehabilitation May 2023To evaluate the effect of preventive interventions for lateral ankle sprain in the general population. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To evaluate the effect of preventive interventions for lateral ankle sprain in the general population.
DATA SOURCES
A search of PubMed, EMBASE, Cochrane CENTRAL, Medline, CINAHL, and ClinicalTrials.gov was conducted up to August 2022.
REVIEW METHODS
Randomized controlled trials and prospective cohort studies that evaluated any interventions for preventing lateral ankle sprain were included. Two reviewers independently conducted the search, screening, and data extraction. The methodological quality of each study was assessed using the revised Cochrane risk-of-bias tool for randomized trials or using the Cochrane Risk Of Bias In Non-Randomized Studies tool for prospective cohort studies.
RESULTS
Seventeen studies met the inclusion criteria. Proprioceptive training exhibited better effects on preventing future lateral ankle sprain compared with the control group (risk ratio = 0.59, p < 0.001), and a stronger preventive effect was observed in participants with a history of lateral ankle sprain in the subgroup analysis (risk ratio = 0.49, p = 0.02). Compared with no bracing, ankle bracing had no significant better effect in preventing lateral ankle sprain (risk ratio = 0.43, p = 0.05). Proprioceptive training and ankle bracing had similar preventive effects (risk ratio = 0.98, p = 0.97). Limited evidence hindered the synthesis of data on pain, swelling, costs, and time loss.
CONCLUSION
Proprioceptive training is recommended for preventing lateral ankle sprain, especially for people with a history of lateral ankle sprain. Bracing seems to have an ambiguous preventive effect and requires more further investigation.
Topics: Humans; Sprains and Strains; Prospective Studies; Ankle Joint; Physical Therapy Modalities; Ankle Injuries
PubMed: 36630892
DOI: 10.1177/02692155221137640 -
Foot and Ankle Clinics Jun 2023Not all ankle sprains are the same and not all ankles behave the same way after an injury. Although we do not know the mechanisms behind an injury producing an unstable... (Review)
Review
Not all ankle sprains are the same and not all ankles behave the same way after an injury. Although we do not know the mechanisms behind an injury producing an unstable joint, we do know ankle sprains are highly underestimated. While some of the presumed lateral ligament lesions might eventually heal and produce minor symptoms, a substantial number of patients will not have the same outcome. The presence of associated injuries, such as additional medial chronic ankle instability, chronic syndesmotic instability, has been long discussed as a possible reason behind this. To explain multidirectional chronic ankle instability, this article aims to present the literature surrounding the condition and its importance nowadays.
Topics: Humans; Ankle; Ankle Joint; Joint Instability; Sprains and Strains; Ankle Injuries
PubMed: 37137631
DOI: 10.1016/j.fcl.2023.01.012 -
Journal of Athletic Training Jun 2021To evaluate the evidence regarding the association between lateral ankle sprain (LAS) history and the subsequent LAS risk, as well as sex differences in the observed...
OBJECTIVE
To evaluate the evidence regarding the association between lateral ankle sprain (LAS) history and the subsequent LAS risk, as well as sex differences in the observed associations.
DATA SOURCES
PubMed, CINAHL, and SPORTDiscus were searched through July 2020 for articles on LAS history and incidence during the study period.
STUDY SELECTION
Studies were included if they were prospective in nature and the authors reported the number of participants with and those without a history of LAS at study initiation as well as the number of participants in each group who sustained an LAS during the investigation.
DATA EXTRACTION
Data were study design parameters as well as the number of participants with and those without an LAS history and the number of subsequent LASs that occurred in both groups. Risk ratios (RRs) with 95% CIs compared the risk of LAS during the study period between those with and those without an LAS history for each investigation.
DATA SYNTHESIS
A total of 19 studies involving 6567 patients were included. The follow-up periods ranged from 14 weeks to 2 years. Assessment scores indicated the studies were of moderate to high quality. A significantly higher risk of LAS during the study period was observed among those with a history of LAS in 10 of 15 studies (RR range = 1.29-6.06). Similar associations were seen in 4 of 6 studies of all-male samples (RR range = 1.38-8.65) and 1 of 4 studies with an all-female sample (RR = 4.28).
CONCLUSIONS
Strong evidence indicates that a previous LAS increased the risk of a subsequent LAS injury. Men with a history of LAS appeared to be at a higher risk of sustaining a subsequent LAS, but women were not. However, further data are needed to draw definitive conclusions from the limited number of sex-specific studies.
Topics: Ankle Injuries; Female; Humans; Incidence; Male; Sprains and Strains
PubMed: 34375983
DOI: 10.4085/1062-6050-168-20 -
International Journal of Occupational... Dec 2019A literature review of the application of kinesio taping in the prevention of professional dancers' injuries indicated frequent dance-related and overuse injuries and a... (Review)
Review
A literature review of the application of kinesio taping in the prevention of professional dancers' injuries indicated frequent dance-related and overuse injuries and a lack of organized information about this issue. This study aimed to assess the impact of kinesio taping on the musculoskeletal system of dancers, based on scientific research data from 2015-2017. The analysis revealed that kinesio taping can effectively reduce muscle spasms, rebuild muscle strength of the injured extremity, improve static and dynamic balance and ease pain, due to its ability to improve proprioception of joints and regulate muscle tone. These effects reduce muscle imbalance and joint instability, thus increasing treatment efficacy and shortening the physical load limitation. Kinesio taping significantly reduces the risk of overuse syndromes and dance-related injuries during dance training and strenuous exercises of people with chronic musculoskeletal diseases. Therefore, kinesio taping has broad utility in primary and secondary prevention of dance-related injuries.
Topics: Athletic Tape; Cumulative Trauma Disorders; Dancing; Humans; Musculoskeletal Diseases; Occupational Injuries
PubMed: 29370731
DOI: 10.1080/10803548.2018.1433281 -
Australian Journal of General Practice 2020Most general practices will have patients who have more than a passing interest in fitness and exercise. These range from the elite athlete to the recreational...
BACKGROUND
Most general practices will have patients who have more than a passing interest in fitness and exercise. These range from the elite athlete to the recreational enthusiast. These patients are highly motivated, but treating them can be challenging.
OBJECTIVE
The aims of this article are to increase awareness of the management of a number of overuse injuries frequently seen in athletes, to assist in understanding the mindset of the athlete in relation to his or her injuries and to indicate the importance of a confident approach to these problems and a multidisciplinary management plan in facilitating a successful outcome.
DISCUSSION
Athletes generally have dynamic personalities and high standards for themselves and others. Complete rest can be anathema to them. Fortunately, in cases of tendinopathy, a structured exercise program is an important component of management. A proactive approach, often with the assistance of a physiotherapist, is likely to improve outcomes.
Topics: Athletes; Australia; Cumulative Trauma Disorders; Humans
PubMed: 32008271
DOI: 10.31128/AJGP-07-19-5016 -
Clinics in Sports Medicine Oct 2020Lisfranc injuries can be devastating to the athlete and nonathlete. In the athletic population, minor loss of midfoot stability compromises the high level of function... (Review)
Review
Lisfranc injuries can be devastating to the athlete and nonathlete. In the athletic population, minor loss of midfoot stability compromises the high level of function demanded of the lower extremity. The most critical aspect of treatment is identifying the injury and severity of the ligamentous/articular damage. Not all athletes are able to return to their previous level of function. With appropriate treatment, a Lisfranc injury does not mandate the cessation of an athletic career. We focus on the diagnosis and an algorithmic approach to treatment in the athlete discussion the controversy of open reduction and internal fixation versus arthrodesis.
Topics: Arthrodesis; Athletic Injuries; Foot Injuries; Fracture Dislocation; Fracture Fixation, Internal; Humans; Ligaments, Articular; Open Fracture Reduction; Sprains and Strains
PubMed: 32892966
DOI: 10.1016/j.csm.2020.07.001