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Toyooka T1, Ishizaki T1, Takata A1, Sugiura S1,2, Okamoto Y3, Nishikawa S3
1Nishikawa Orthopaedic Clinic, Rehabilitation, Sakura, Japan, 2Chiba University, Orthopedic, Chiba, Japan, 3Nishikawa Orthopaedic Clinic, Sakura, Japan
Background: Weight-bearing pain (WBP) is one of the symptoms of lateral ankle sprain. Previously, WBP was reported to influence return to sports activities more than local swelling or limited range of motion. In such cases, a short period (1-3 weeks) of plaster immobilization or similar rigid support facilitates rapid decrease in local pain, swelling, and WBP. In addition, previous studies have reported that magnetic resonance imaging (MRI) features did not significantly influence clinical outcome, including the presence of a bone bruise of the talus. Despite receiving these treatments, some patients suffered from WBP for a long time, especially patients with a talus bone bruise tend to suffer from prolonged WBP. This was our clinical experience as opposed to previous reports. Thus, it is unclear what factors may influence prolonged WBP after ankle sprain with a bone bruise of the talus.
Purpose: We investigated the factors influencing the improvement of WBP after lateral ankle sprain with bone bruise of the talus.
Methods: We reviewed the medical records of outpatients diagnosed with lateral ankle sprain within one month after injury. The inclusion criteria were WBP for at least three weeks and a bone bruise of the talus on diagnostic MRI. Of the 74 potentially relevant patients, 16 met the inclusion criteria(7 men, 9 women; mean age = 22.6±12.6 years). From the medical records, we examined whether the patients had a restriction of ankle dorsiflexion for at least three weeks, the period of improvement of the WBP, and demographic data (age, body mass index, sex). The data were analyzed using Spearman's rank correlation coefficient. For the parameters that showed correlation, regression analysis was used for predicting the period of improvement of the WBP.
Results: The results of Spearman's rank correlation coefficient showed that only sex exhibited a significant correlation with WBP (r = 0.59, p 0.05). The formula applied for predicting the period of improvement of the WBP using regression analysis was as follows (male, 0; female, 1): WBP = 38.86 + 36.37 × sex (r = 0.6, r2 = 0.36).
Conclusion(s): The analysis showed that although sex was associated with prolonged WBP, restriction of ankle dorsiflexion was not associated. As a sequelae of lateral ankle sprain, restriction of ankle dorsiflexion has been reported along with WBP. However, it was indicated that they may not affect each other. Moreover, regression analysis showed that females had one month longer treatment period than males. Since the contribution rate (r) is low, there may be other factors that may affect WBP. It is generally known that females have lower muscular strength than males and have greater joint laxity. Therefore, further studies are required to investigate the relationship among WBP, muscular strength, and joint laxity.
Implications: Clinically, therapists should consider patients' sex when treating WBP after lateral ankle sprain with bone bruise of the talus.
Keywords: Weight-bearing pain, bone bruise of the talus, lateral ankle sprain
Funding acknowledgements: This research did not receive any specific grant from agencies in the public, commercial, or not-for-profit sectors.
Purpose: We investigated the factors influencing the improvement of WBP after lateral ankle sprain with bone bruise of the talus.
Methods: We reviewed the medical records of outpatients diagnosed with lateral ankle sprain within one month after injury. The inclusion criteria were WBP for at least three weeks and a bone bruise of the talus on diagnostic MRI. Of the 74 potentially relevant patients, 16 met the inclusion criteria(7 men, 9 women; mean age = 22.6±12.6 years). From the medical records, we examined whether the patients had a restriction of ankle dorsiflexion for at least three weeks, the period of improvement of the WBP, and demographic data (age, body mass index, sex). The data were analyzed using Spearman's rank correlation coefficient. For the parameters that showed correlation, regression analysis was used for predicting the period of improvement of the WBP.
Results: The results of Spearman's rank correlation coefficient showed that only sex exhibited a significant correlation with WBP (r = 0.59, p 0.05). The formula applied for predicting the period of improvement of the WBP using regression analysis was as follows (male, 0; female, 1): WBP = 38.86 + 36.37 × sex (r = 0.6, r2 = 0.36).
Conclusion(s): The analysis showed that although sex was associated with prolonged WBP, restriction of ankle dorsiflexion was not associated. As a sequelae of lateral ankle sprain, restriction of ankle dorsiflexion has been reported along with WBP. However, it was indicated that they may not affect each other. Moreover, regression analysis showed that females had one month longer treatment period than males. Since the contribution rate (r) is low, there may be other factors that may affect WBP. It is generally known that females have lower muscular strength than males and have greater joint laxity. Therefore, further studies are required to investigate the relationship among WBP, muscular strength, and joint laxity.
Implications: Clinically, therapists should consider patients' sex when treating WBP after lateral ankle sprain with bone bruise of the talus.
Keywords: Weight-bearing pain, bone bruise of the talus, lateral ankle sprain
Funding acknowledgements: This research did not receive any specific grant from agencies in the public, commercial, or not-for-profit sectors.
Topic: Sport & sports injuries; Orthopaedics; Pain & pain management
Ethics approval required: Yes
Institution: Nishikawa Orthopedic Clinic
Ethics committee: Ethical Review Committee of Nishikawa Orthopaedic clinic
Ethics number: 2433
All authors, affiliations and abstracts have been published as submitted.
