Surgical Versus Functional Treatment for Acute Ruptures of the Lateral Ligament Complex of the Ankle in Young Males - A Randomized Controlled Trial With a Mean of 14 Years Follow-up

Finnish Defense Forces

Status: Completed

Conditions: Ankle Injury

Treatments: Procedure: lateral ligament surgery; Device: functional treatment

Study type: Interventional

Funder types: Other

Identifiers

NCT00954330

555555

Details and patient eligibility

About

The aim of this prospective randomized controlled trial was to compare the effectiveness of surgical and conservative treatment in acute lateral ligament injury of ankle. The more detailed aims were to assess the function, physical activity level, re-injuries, objective stability and radiographic changes seen by magnetic resonance imaging in patients randomized to surgery or to functional treatment after a mean of 14 years follow-up.

Enrollment: 51 patients

Sex: Male

Ages: 19 to 25 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The inclusion criteria included positive stress radiographs (in all cases) and arthrography 15 (5 cases) proven fibulotalar anterior (FTA) and fibulocalcanear (FC) ligament injury.
• The positive findings for a lateral ligament injury included a clinically unstable ankle and a radiological talar tilt >6 degrees or ADS >5 mm compared with the uninjured opposite ankle.

Exclusion criteria

• The exclusion criteria for the study were diabetes, inflammatory arthritis, previous severe trauma, pre-existing instability of joints.
• In addition, patients were excluded from our study if they had previously undergone surgery of the ankle region.

Trial design

51 participants in 2 patient groups

surgery

Experimental group

Description:

All twenty-five patients underwent ligament repair, where the ruptured ends of the FTA (in 11 cases) or FTA and FC (in 14 cases) ligaments were rejoined by using absorbable sutures. A supine position and a tourniquet were used. A curvilinear skin incision of 5-10 cm was made; the retinacular structures were incised and the hematoma was removed.

Treatment:

Procedure: lateral ligament surgery

functional treatment

Active Comparator group

Description:

Twenty-six patients randomized to the functional treatment received a functional light-weight orthotic device (Air-Cast ankle brace, Summit, New Jersey) for 3 weeks. Full weight bearing was allowed. The ankle brace allowed dorsi- and plantarflexion but it restricted inversion and eversion of the ankle

Treatment:

Device: functional treatment