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Toyooka T1, Ishizaki T1, Takata A1, Sugiura S1,2, Okamoto Y1, Nishikawa S1
1Nishikawa Orthopaedic Clinic, Sakura, Japan, 2Chiba University, Chiba, Japan
Background: The restriction of ankle dorsiflexion is one of the sequelae of lateral ankle sprain. Some factors that may influence the sequelae have been reported; however, no consensus has been reached. Additionally, talar glide therapy may improve the restriction of ankle dorsiflexion. Nevertheless, some patients are resistant to the treatment. Particularly, patients with bone bruise of the talus are likely to experience a prolonged restriction of ankle dorsiflexion. Insole treatment may improve this symptom although treatment outcome remains unclear.
Purpose: This study aimed to investigate the efficacy of insole treatment for the restriction of ankle dorsiflexion after lateral ankle sprain with bone bruise of the talus.
Methods: We evaluated the medical records of outpatients who were diagnosed with lateral ankle sprain within 1 month of trauma and underwent diagnostic magnetic resonance imaging (MRI). Inclusion criteria were the presence of the restriction of ankle dorsiflexion and bone bruise of the talus on MRI. Of the 74 potentially relevant patients, 14 met the inclusion criteria. Patients were divided into traditional and insole groups. The insole group included patients who received insole treatment within 2 months after first visit to our clinic. Improvement rate, average duration for the improvement of the restriction of ankle dorsiflexion, and ratio of anterior talofibular ligament (ATFL) tear were compared between the two groups. Categorical variables were compared using Fisher's exact test, and continuous variables were analyzed using Student's t-test.
Results: Statistical analyses showed that the improvement rate (traditional group: n = 2/7, insole group: n = 7/7; p 0.05) and average duration for the improvement of the restriction of ankle dorsiflexion (traditional group: 113.6 ± 41.5 days, insole group: 56.7 ±24.6 days; p 0.05) were significantly different between the two groups. No significant difference was observed in the ratio of ATFL tear (traditional group: n = 7/7; insole group: n = 6/7).
Conclusion(s): Our findings suggest that insole treatment may be effective for patients with the restriction of ankle dorsiflexion after lateral ankle sprain with bone bruise of the talus. Insole treatment could support medial longitudinal arch. Thus some patients might compensate with a flat foot after lateral ankle sprain because of the fear of recurrent sprain. Flat foot might cause abnormal talus motion and result in the restriction of ankle dorsiflexion. One of the limitations of this study is that medial longitudinal arch height are not investigated. Future studies should be investigated of the medial longitudinal arch for such patients.
Implications: Insole treatment should be considered one of the methods to improve the restriction of ankle dorsiflexion after sprain. It may shorten the treatment period and improve outcomes.
Keywords: insole treatment, restriction of ankle dorsiflexion, bone bruise of talus
Funding acknowledgements: This research did not receive any specific grant from agencies in the public, commercial, or not-for-profit sectors.
Purpose: This study aimed to investigate the efficacy of insole treatment for the restriction of ankle dorsiflexion after lateral ankle sprain with bone bruise of the talus.
Methods: We evaluated the medical records of outpatients who were diagnosed with lateral ankle sprain within 1 month of trauma and underwent diagnostic magnetic resonance imaging (MRI). Inclusion criteria were the presence of the restriction of ankle dorsiflexion and bone bruise of the talus on MRI. Of the 74 potentially relevant patients, 14 met the inclusion criteria. Patients were divided into traditional and insole groups. The insole group included patients who received insole treatment within 2 months after first visit to our clinic. Improvement rate, average duration for the improvement of the restriction of ankle dorsiflexion, and ratio of anterior talofibular ligament (ATFL) tear were compared between the two groups. Categorical variables were compared using Fisher's exact test, and continuous variables were analyzed using Student's t-test.
Results: Statistical analyses showed that the improvement rate (traditional group: n = 2/7, insole group: n = 7/7; p 0.05) and average duration for the improvement of the restriction of ankle dorsiflexion (traditional group: 113.6 ± 41.5 days, insole group: 56.7 ±24.6 days; p 0.05) were significantly different between the two groups. No significant difference was observed in the ratio of ATFL tear (traditional group: n = 7/7; insole group: n = 6/7).
Conclusion(s): Our findings suggest that insole treatment may be effective for patients with the restriction of ankle dorsiflexion after lateral ankle sprain with bone bruise of the talus. Insole treatment could support medial longitudinal arch. Thus some patients might compensate with a flat foot after lateral ankle sprain because of the fear of recurrent sprain. Flat foot might cause abnormal talus motion and result in the restriction of ankle dorsiflexion. One of the limitations of this study is that medial longitudinal arch height are not investigated. Future studies should be investigated of the medial longitudinal arch for such patients.
Implications: Insole treatment should be considered one of the methods to improve the restriction of ankle dorsiflexion after sprain. It may shorten the treatment period and improve outcomes.
Keywords: insole treatment, restriction of ankle dorsiflexion, bone bruise of talus
Funding acknowledgements: This research did not receive any specific grant from agencies in the public, commercial, or not-for-profit sectors.
Topic: Musculoskeletal: lower limb; Sport & sports injuries; Pain & pain management
Ethics approval required: Yes
Institution: Nishikawa Orthopaedic Clinic
Ethics committee: Ethical Review Committee of Nishikawa Orthopaedic clinic
Ethics number: 2432
All authors, affiliations and abstracts have been published as submitted.
