Acute Lateral Ankle Instability

Acute injuries to the lateral ankle complex remain common and account for 20% to 25% of musculoskeletal injuries. Initial assessment should use the Ottawa ankle rules, and grading should take into account degree of mechanical instability. Nonoperative measures are preferable for all grades of injury; however, mechanical instability is a predictor for resprains. Functional treatment after a short period of relative immobilization gives satisfactory results, and residual chronic ankle instability can be managed by repair or reconstruction. Delayed physical examination in elite athletes, along with 3T MRI, may be helpful in making a case for early surgical stabilization.