SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
Chronic ankle instability has no correlation with the number of ruptured ligaments in severe anterolateral sprain: a systematic review and meta-analysis.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Surgical outcome of avulsion fractures of the distal fibula: a systematic literature review.Archives of orthopaedic and trauma surgery · 2023Pooled it
- Incisura groove depth is associated with reduced rotational fibular displacement after syndesmotic injury: cadaveric validation of an automated three-dimensional incisura morphometric pipeline.Frontiers in medicine · 2026Article
- Development and internal validation of a preliminary nomogram for the early prediction of chronic ankle instability following a first-episode lateral ankle sprain with acute-phase MRI indication.Frontiers in sports and active living · 2026Article
- Does joint mobilization effectively improve chronic ankle instability ? A systematic review and meta-analysis.Frontiers in medicine · 2025Article
- Recent advances in the management of chronic ankle instability.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2025Review
- Comparison of Inferior Extensor Retinacular Reinforcement Versus Nonreinforcement in Arthroscopic Isolated Anterior Talofibular Ligament Repair for Chronic Lateral Ankle Instability: A Systematic Review and Meta-analysis.Orthopaedic journal of sports medicine · 2024Article
- Chronic lateral ankle instability using anterior tibiofibular ligament distal fascicle transfer augmentation repair: an anatomical, biomechanical, and histological study.Frontiers in bioengineering and biotechnology · 2024Article
- Risk factors for chronic ankle instability after first episode of lateral ankle sprain: A retrospective analysis of 362 cases.Journal of sport and health science · 2023Article
- The lasso-loop technique is equivalent to the simple suture technique in arthroscopic anterior talofibular ligament repair.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Injury severity at the time of sport-related ankle sprain is associated with symptoms and quality of life in young adults after 3-15 years.Annals of medicine · 2023Article
- Magnetic Resonance Accuracy in the Diagnosis of Anterior Talo-Fibular Ligament Acute Injury: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2021Review
- Current concepts in the surgical management of chronic ankle lateral ligament instability.Journal of orthopaedicsReview
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDespite being a significant public health problem, ankle sprains' prognostic factors are largely unknown. This review aimed to systematically analyze the literature on acute ankle sprains to compare the prognosis of a combined anterior talofibular (ATFL) and calcaneofibular (CFL) ligaments rupture with an isolated ATFL rupture in terms of progression to chronic ankle instability and other clinical outcomes.
methodsThe databases for Pubmed, CENTRAL and Web of Science were searched. Clinical studies reporting the prognostic effect of combined ATFL-CFL rupture versus an isolated ATFL rupture in conservatively treated ankle sprains, with a minimum follow-up of 12 months, were eligible for inclusion. Only studies with a reliable diagnostic method for anterolateral ankle ligaments evaluation, namely ultrasonography, magnetic resonance imaging, arthrography or stress tenography, were included. The relative risk (RR), along with the 95% confidence interval (CI), was used to quantitatively analyze the main outcomes.
resultsNine papers were selected for inclusion, of which five were suitable for quantitative analysis. None of them found a statistically significant correlation between ligament injury severity and progression to chronic instability. Concerning other clinical outcomes, three studies found a statistically significant correlation between a combined ligament injury and a worse clinical prognosis. From the quantitative analysis, the relative risk (RR) of chronic ankle instability in a single versus a combined ligament rupture showed no significant difference.
conclusionA significant statistical correlation between a combined ATFL-CFL rupture and chronic ankle instability, compared to an isolated ATFL rupture, was not found. There is, however, fair evidence showing a worse clinical outcome score in the combined ruptures, as well as a decreased return to full sports activities. The use of reliable and accessible diagnostic methods to determine the number of ruptured ligaments might have a role in managing severe ankle sprains. LEVEL OF EVIDENCE: Level III.
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