Effects of ankle sprain in a general clinic population 6 to 18 months after medical evaluation

Objective: To assess the 1-year outcome of standard medical care of acute a nkle sprains in a general clinic-based population. Design: A self-administered survey was mailed to all adult patients who pre sented to a health system provider for evaluation of ankle sprain. Setting: A regional primary care health system. Participants: Four hundred sixty-seven (66.5%) of 702 patients with ankle s prains evaluated by a system physician from April 1, 1995, to March 31, 199 6. Main Outcome Measures: Prevalence and severity of self-reported ankle pain, swelling, perceived instability, and perceived weakness 6 to 18 months aft er medical evaluation. Results: Most patients sought medical evaluation shortly after injury and w ere immobilized or braced; 32.7% reported formal or home-based physical the rapy. Six to 18 months after injury, 72.6% reported residual symptoms. Of t hese, 40.4% reported at least 1 moderate to severe symptom, most commonly p erceived ankle weakness; 40.3% were unable to walk 1 mile; and 43.3% were u nable to jump or pivot on the ankle without symptoms. Factors associated wi th moderate to severe residual symptoms were reinjury of the ankle (odds ra tio [OR], 7.21; 95% confidence interval [CI], 4.14-12.68), activity restric tion longer than 1 week (OR, 2.04; 95% CI, 1.25-3.32), and limited weight b earing longer than 28 days (OR, 2.16; 95% CI, 1.28-3.63). Conclusions: Residual lifestyle-limiting symptoms are common 6 to 18 months after an ankle sprain. Ankle sprains may be more problematic than generall y thought, or standard medical treatment may be inadequate. Further studies evaluating treatment regimens are needed to identify effective methods to reduce the long-term functional limitations of ankle sprain in general clin ic populations.