ReviewDeutsches Arzteblatt international2023
Conservative Functional Treatment of Acute Fibular Ligament Rupture of the Ankle.
Review in Deutsches Arzteblatt international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 3 citations in OpenAlex.
- Triage Assessment of Lateral Ankle Sprain Surgical Risk (TALAR Score): Using Early Red Flags to Predict the Failure of Conservative Management.Journal of functional morphology and kinesiology · 2026Article
- Temporal changes in the talofibular distance during ultrasound-guided anterior drawer testing in grade III lateral ankle sprains: a retrospective observational study.Journal of medical ultrasonics (2001) · 2026Article
- [Injuries to the lateral ankle ligaments].Unfallchirurgie (Heidelberg, Germany) · 2025Review
- The Effect of Repairing the Integrity of the Calcaneofibular Ligament During Calcaneal Fracture Surgery on Postoperative Ankle Joint Function.Therapeutics and clinical risk management · 2025Article
- [Injuries of the ankle ligaments].Orthopadie (Heidelberg, Germany) · 2024Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute rupture of the fibular ligament complex is one of the commonest injuries in sports. Prospective randomized trials in the 1980s led to a paradigm shift from primary surgical repair to conservative functional treatment.
methodsThis review is based on publications retrieved by a selective search in PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) and meta-analyses on surgical versus conservative treatment from the years 1983 to 2023.
results10 of 11 prospective randomized trials of surgical versus conservative treatment conducted between 1984 and 2017 did not reveal any significant difference in the overall outcome. These findings were confirmed in two meta-analyses and two systematic reviews that were published between 2007 and 2019. Isolated benefits in the surgical group were outweighed by a variety of postoperative complications. The anterior fibulotalar ligament (AFTL) was ruptured in 58% to 100% of cases, followed by the fibulocalcaneal ligament combined with the LFTA in 58% to 85%, and the posterior fibulotalar ligament (mostly incomplete ruptures) in 1.9% to 3%.
conclusionConservative functional treatment is now the standard treatment in acute fibular ligament rupture of the ankle because it is low-risk, low-cost, and safe. Primary surgery is indicated in only 0.5% to 4% of cases. Physical examination for tenderness to palpation and for stability, as well as stress ultrasonography, can be used to differentiate sprains from ligamentous tears. MRI is superior only for the detection of additional injuries. Stable sprains can be successfully treated with an elastic ankle support for a few days, and unstable ligamentous ruptures with an orthosis for 5 to 6 weeks. Subsequent physiotherapy with proprioceptive exercises is the best way to prevent recurrent injury.
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