Surgery versus functional treatment in ankle ligament tears. A prospective study

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation Science

Background:

• Severe (Grade III) lateral ligament injuries of the ankle often present treatment challenges.
• Comparing surgical repair with functional rehabilitation is crucial for optimizing patient recovery.
• Early controlled mobilization is a key component in managing ankle ligamentous injuries.

Purpose of the Study:

• To prospectively compare surgical treatment (primary repair + early mobilization) versus functional treatment (early mobilization alone) for severe lateral ankle ligament injuries.
• To evaluate the efficacy of each treatment modality based on ankle stability, range of motion, and subjective/functional outcomes.

Main Methods:

• A prospective study involving 60 patients with Grade III lateral ankle ligament injuries.
• Thirty patients underwent surgical treatment (primary repair + early controlled mobilization).
• Thirty matched patients received functional treatment (early controlled mobilization alone).

Main Results:

• Both groups achieved ankle stability at 9 months, with only one patient in each group remaining unstable.
• The surgical group experienced restricted ankle range of motion at 6 weeks, which persisted, unlike the functional group.
• At 9 months, 87% of functionally treated patients achieved excellent or good scores, compared to 60% of surgically treated patients.

Conclusions:

• Functional treatment involving early controlled mobilization alone yields superior subjective and functional outcomes for severe lateral ankle ligament tears.
• Surgical intervention combined with early mobilization may lead to persistent range of motion deficits.
• Early mobilization is recommended as a primary treatment strategy for complete lateral ankle ligament tears.