LATERAL ANKLE SPRAIN WITH A TALOTIBIAL CONTUSION RESULTS IN PROLONGED WALKING PAIN

T. Toyooka¹, S. Sugiura^2,1, Y. Omori¹, A. Takata¹, K. Nakamura¹, T. Shiga¹, T. Ishizaki¹, Y. Okamoto¹, S. Nishikawa¹

¹Nishikawa Orthopaedic Clinic, Rehabilitation, Sakura, Japan, ²Chiba University, Orthopaedic Surgery, Chiba, Japan

Background: Lateral ankle sprains have been associated with prolonged walking pain as a prognostic factor. Bone contusions may cause this pain, but some reports state that they are unrelated, and the issue remains controversial. We have reported prolonged pain while walking in patients with talar bone contusions although some patients have shorter pain. The clinical question is, do talus bone contusions cause pain for different lengths of time depending on the contusion location?

Purpose: This study investigated whether the duration of the resolution of walking pain differs depending on the bone contusion site of the talus bone.

Methods: Fifteen subjects (mean age 24.5 ± 13.8 years, 6 males and 9 females) who visited our clinic within 1 week of injury were diagnosed with a lateral ankle sprain. They underwent magnetic resonance imaging (MRI) within 1 month of injury and had a bone contusion in the talus. All subjects experienced walking pain at the time of the initial examination. The research items were gender, age, body mass index, duration of illness, duration of cast splint immobilization, presence of an anterior talofibular ligament injury, number of days until the resolution of walking pain, and site of talar bone contusion on MRI. Subjects were divided into two groups according to the talus bone contusion site: talotibial joint side group (n ＝ 6) and subtalar joint side group (n ＝ 9). The duration until the disappearance of walking pain was compared. Statistical analysis was performed with an unpaired t-test with a p < 0.05 considered significant. Our institutional review board approved this study (approval no. 2450).

Results: The number of days until the disappearance of walking pain in each group was 50.5 ± 25.7 days in the talotibial joint side group and 27.7 ± 21.6 days in the subtalar joint side group respectively. The statistically significant results showed that the number of days until the disappearance of walking pain was longer in the talotibial joint side group (p < 0.05). No significant differences were found in other items.

Conclusions: Among talus bone contusions, the bone contusion on the talotibial joint side seems to result in longerduration of pain experienced while walking. The talus has several load-bearing joints, andthe talotibial joint surface is narrower than the subtalar joint surface. It was thought that stress due to loading might be more concentrated.

Implications: The presence of a bony contusion on the talotibial joint side of the talus suggests the need of longer protection of the joint.

Funding acknowledgements: nothing to declare

Keywords:
Lateral ankle sprain
Magnetic resonance imaging
Bone contusion in the talus

Topics:
Sport & sports injuries
Musculoskeletal: lower limb
Pain & pain management

Did this work require ethics approval? Yes

Institution: nishikawa orthopaedic clinic

Committee: Ethical Review Committee of Nishikawa Orthopaedic Clinic

Ethics number: 2450