[Distorsion or rupture of ankle ligaments?]

In the Netherlands, almost 500,000 patients visit a physician each year because of an ankle inversion trauma. Most people are seen by a general practitioner, but a considerable number go directly to an emergency department. Recently a nation-wide accepted strategy for diagnosis and treatment of these lesions was formulated. This strategy includes the use of the Ottawa ankle rules, a second physical examination after four to five days if there is severe swelling of the ankle and functional treatment with inelastic tape bandage or brace application in case of an established rupture of the lateral band complex. At present, however, the efficacy of a second physical examination in primary health care has not been analysed and the economic consequences of the new strategy are unknown. From a scientific point of view none of the types of conservative treatment is preferable to another. Further scientific studies are needed.