Lateral Ankle Joint Injuries in Indoor and Court Sports: A Systematic Video Analysis of 445 Nonconsecutive Case Series.

BACKGROUND: Lateral ankle sprains are one of the most common injuries in indoor and court sports. Self-reports and case studies have indicated that these injuries occur via both contact and noncontact injury mechanisms typically because of excessive inversion in combination with plantarflexion and adduction of the foot. Video-based documentation of the injury mechanism exists, but the number of cases reported in the literature is limited. PURPOSE: To retrieve and systematically analyze a large number of video-recorded lateral ankle injuries from indoor and court sports, as well as describe the injury mechanism, injury motion, and injury pattern across different sports. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A total of 445 unique video-recorded lateral ankle sprain injuries were retrieved from indoor and court sports of broadcasted levels of competition. The videos were independently analyzed by 2 different reviewers. Outcomes included classification of the injury mechanism according to the International Olympic Committee consensus guidelines, primary and secondary motions of ankle joint distortion, and documentation of the fixation point (fulcrum) around which the foot rotates. RESULTS: Overall, 298 (67%) injuries were direct contact, 113 (25%) were noncontact, and 32 (7%) were indirect contact incidents. Direct contact injuries were especially prevalent in basketball (76%), handball (80%), and volleyball (85%), while noncontact injuries dominated in tennis and badminton (96% vs 95% across both). Inversion (65%) and internal rotation (33%) were the primary distortion motions, with the lateral forefoot (53%) and lateral midfoot (40%) serving as the main fulcrums. Landing on another player's foot was the leading cause of injury (n = 246; 55%), primarily characterized by inversion (79%) around a midfoot fulcrum (54%). The noncontact and indirect landings on floor (n = 144; 33%) were primarily characterized by a distortion around a forefoot fulcrum (69%). CONCLUSION: Two of 3 ankle sprains from online video platforms were direct contact injuries, with most involving landing on another player's foot. The distortion motion seems to be related to the injury mechanism and the fixation point between the foot and the floor. The injury mechanisms varied greatly between sports, and future studies should clearly differentiate and investigate the specific injury mechanisms.

Validity and Reliability of Hindi version of Foot and Ankle Disability Index in patients with chronic recurrent lateral ankle sprain.

BACKGROUND: Lateral Ankle Sprain (LAS) is a recurrent musculoskeletal injury commonly noticed in primary care, podiatry, orthopaedics, and physical therapy centers. The Foot and Ankle Disability Index (FADI) is a self-reported and region-specific tool with no previous literature available on the translation of the FADI scale into Hindi language. AIM: The study aims to translate and evaluate each translated domain of FADI to see its cross-cultural adaptation, content validity and reliability for patients with chronic recurrent LAS. STUDY DESIGN: A Cross-Sectional Study. METHODS: The scale was translated from the reference language to the target language, Hindi, using the instructions provided in the literature. Delphi survey was conducted for content validation followed by recruitment of 51 participants with a history of long lasting repetitive lateral sprain of ankle to evaluate test-retest reliability of Hindi version of FADI. RESULT: The S-CVI/Ave and S-CVI/UA came out to be 0.988 and 0.884, respectively and I-CVI for all items of Hindi version of FADI were more than 0.90. The ICC (Intra-class Correlation Coefficient) and internal consistency was evaluated, which came out to 0.961 and 0.980, respectively for Hindi version of FADI. CONCLUSION: Hindi version of FADI is a valid and reliable scale that has been translated and adapted to be implemented among Indian population suffering from long lasting repetitive LAS.

COMPARATIVE ANALYSIS OF THE EFFECTIVENESS OF CLINICAL DATA COLLECTION THROUGH ONLINE AND PHYSICAL ELECTRONIC QUESTIONNAIRE IN ORTHOPEDIC PATIENTS.

The collection of clinical data is an essential step for the development of any scientific research. Online digital data collection can optimize this step. Objective: To compare the response rate and the accuracy of the clinical data collection date through the online and physical digital questionnaire in orthopedic patients. Methods: Comparative study, level III of evidence, with forty patients who had ankle sprains were evaluated, followed up for a period of 12 weeks with the application of physical and digital Visual Analogue Scale, Foot Function Index and Cumberland Ankle Instability Tool questionnaires, and data were collected about the moment of collection of each questionnaire. Results: We obtained a response rate of 83.3% in the digital collection group and 60% in the physical collection group (p < 0.05), and the response rate in the digital collection group was higher at all times of collection (3, 6 and 12 weeks). Analysis of the time of collection shows greater variability in the larger physical collection group at all times of the study (2.8 vs 1.5; 4.0 vs 2.4; 8.6 vs 1.5). Conclusion: Digital data collection is effective for obtaining clinical data in patients with ankle sprains. Level of Evidence III, Comparative, Prospective, Longitudinal Study in Parallel Groups.

A coleta de dados clínicos é etapa essencial para o desenvolvimento de qualquer pesquisa científica, e a coleta de dados digital online pode otimizá-la. Objetivo: Comparar o índice de resposta e a precisão da data de coleta de dados clínicos por meio de aplicação de questionário digital online e físico a pacientes ortopédicos. Métodos: Estudo comparativo realizado com 40 pacientes que apresentaram entorse de tornozelo, acompanhados pelo período de 12 semanas, com aplicação dos questionários escala visual analógica, foot function index e Cumberland ankle instability tool físicos e digitais. Além disso, foram recolhidos dados sobre o momento da coleta dos questionários. Resultados: Obtivemos índice de resposta de 83,3% no grupo de coleta digital e 60% no grupo de coleta física (p < 0,05), sendo que o índice de resposta no grupo de coleta digital foi maior em todos os momentos de coleta (3, 6 e 12 semanas). A análise do momento da coleta apresenta maior variabilidade no grupo de coleta física em todos os momentos do estudo (2,8 vs 1,5; 4,0 vs 2,4; 8,6 vs 1,5). Conclusão: A coleta de dados digital é efetiva para a obtenção dos dados clínicos de pacientes que apresentam entorse do tornozelo. Nível de Evidência III, Estudo Comparativo, Prospectivo, Longitudinal em Grupos Paralelos.

Ankle Sprains in Athletes: Current Epidemiological, Clinical and Imaging Trends.

Purpose: Ankle injuries are frequent sports injuries. Despite optimizing treatment strategies during recent years, the percentage of chronification following an ankle sprain remains high. The purpose of this review article is, to highlight current epidemiological, clinical and novel advanced cross-sectional imaging trends that may help to evaluate ankle sprain injuries. Methods: Systematic PubMed literature research. Identification and review of studies (i) analyzing and describing ankle sprain and (ii) focusing on advanced cross-sectional imaging techniques at the ankle. Results: The ankle is one of the most frequently injured body parts in sports. During the COVID-19 pandemic, there was a change in sporting behavior and sports injuries. Ankle sprains account for about 16-40% of the sports-related injuries. Novel cross-sectional imaging techniques, including Compressed Sensing MRI, 3D MRI, ankle MRI with traction or plantarflexion-supination, quantitative MRI, CT-like MRI, CT arthrography, weight-bearing cone beam CT, dual-energy CT, photon-counting CT, and projection-based metal artifact reduction CT may be introduced for detection and evaluation of specific pathologies after ankle injury. While simple ankle sprains are generally treated conservatively, unstable syndesmotic injuries may undergo stabilization using suture-button-fixation. Minced cartilage implantation is a novel cartilage repair technique for osteochondral defects at the ankle. Conclusion: Applications and advantages of different cross-sectional imaging techniques at the ankle are highlighted. In a personalized approach, optimal imaging techniques may be chosen that best detect and delineate structural ankle injuries in athletes.

Epidemiology of Musculoskeletal Injuries Among Naval Special Warfare Personnel.

BACKGROUND: Musculoskeletal injuries (MSIs) are an important cause of morbidity in the military, especially among Special Forces. The aim of this analysis was to describe MSIs among two groups of Naval Special Warfare (NSW) personnel-Special Warfare Combatant-Craft Crewman (SWCC) Operators and Crewman Qualification Training (CQT) students. METHODS: In this cross-sectional study, we describe self-reported MSIs that occurred during a one-year period and the calculated financial costs of MSIs. Group comparisons were conducted using Fisher's exact tests and independent samples t tests. RESULTS: Data were available for 142 SWCC Operators (26.9 ± 5.9 years, 1.8 ± 0.1 meters, 85.4 ± 10.4 kilograms) and 187 CQT students (22.8 ± 3.2 years, 1.8 ± 0.2 meters, 81.4 ± 8.9 kilograms). The one-year cumulative MSI incidence was significantly lower among SWCC Operators (21.1%) compared to CQT students (37.4%, p = 0.002). The most common anatomic location for MSIs was the lower extremity (SWCC: 50.0% of MSIs, CQT: 66.3%). Physical training was the predominant activity when MSIs occurred (SWCC: 31.6%, CQT: 77.6%). The lifetime cost of all the MSIs included in the analysis was approximately $580,000 among 142 SWCC Operators and $1.2 million among 187 CQT students. CONCLUSION: MSIs, especially those affecting the lower extremity and occurring during physical training, cause considerable morbidity and financial burden among NSW personnel. Many of the musculoskeletal injuries are to musculotendinous tissue, which typically results from tissue overload or inadequate recovery. Further investigation of the preventable causes of these MSIs and development of a customized, evidence-based MSI prevention program is required to reduce the burden of these MSIs.

Risk factors for acute ankle sprains in field-based, team contact sports: a systematic review of prospective etiological studies.

OBJECTIVE: The aim of this systematic review was to identify prospectively measured ankle sprain risk factors in field-based team contact sports. METHODS: Eight databases including SPORTDiscus, CINAHL Complete, MEDLINE (EBSCO), Education Source, Web of Science, Scopus, Embase, and Pubmed were searched using specific Boolean terms. A modified-CASP diagnostic test assessed the quality of the included studies. Extensive data extraction included but was not limited to injury definition, protocols for injury diagnosis and recording, and outcomes associated with ankle sprain. RESULTS: 4012 records were returned from the online search and 17 studies met the inclusion criteria for this review. Twelve different risk factors including anatomic alignment of the foot and ankle, joint laxity, height, mass, BMI (body mass index), age, ankle strength, hip strength, single leg landing performance (ground reaction force, pelvic internal rotation, and knee varus), and single leg reach were all found to be associated with ankle sprain incidence. Injury definitions and methods of diagnosis and recording varied across the 17 studies. CONCLUSION: This review updates the literature on prospective risk factors for ankle sprain in a specific population rather than heterogeneous cohorts previously studied. From more than 20 categories of risk factors investigated for ankle sprain association across 17 studies in field-based team contact sports, 12 variables were found to be associated with increased incidence of ankle sprain. In order to reduce the risk of ankle sprain, BMI, ankle plantar and dorsiflexion strength, hip strength, and single leg landing performance should be factored in to athlete assessment and subsequent program design. More studies utilizing standardized definitions and methods of recording and reporting are needed. Future prospective etiological studies will allow strength and conditioning coaches, physiotherapists, and physicians to apply specific training principles to reduce the risk and occurrence of ankle sprain injuries.

Pre-existing anxiety and depression disorders and return to work after musculoskeletal strain or sprain: a phased-based approach.

PURPOSE: To examine the impact of pre-existing anxiety and depression disorders on return to work (RTW) using a phase-based approach. METHODS: Accepted lost-time workers' compensation claims for upper limb or spine strain or sprain from 2009 to 2013 were extracted for workers in the Canadian province of British Columbia (n = 78,186). Pre-existing anxiety and depression disorders were identified using health claims data. Probability of RTW following a first or second work lost-time episode was analyzed using Prentice, Williams and Peterson models for recurrent events (common hazards ratios (cHR)). Probability of a first lost-time recurrence was analyzed using Cox models (HR). All models included two years of follow up and were stratified by gender. RESULTS: For men, anxiety alone (cHR = 0.90, 95% CI: 0.85 to 0.94) or comorbid with depression (cHR = 0.95, 95% CI: 0.92 to 0.99) was significantly associated with a lower probability of RTW, and comorbid anxiety and depression with a higher probability of recurrence (HR = 1.29, 95% CI: 1.13 to 1.48). In women, comorbid anxiety and depression was significantly associated with a lower probability of RTW (cHR = 0.96, 95% CI: 0.93 to 0.99) and a higher probability of recurrence (HR = 1.15, 95% CI: 1.04 to 1.28); and anxiety alone with a higher probability of recurrence (HR = 1.25, 95% CI: 1.09 to 1.43). There was little evidence that depression alone was associated with RTW or recurrence. CONCLUSIONS: Workers with a pre-existing anxiety disorder may require additional supports both during lost-time and after initial RTW.

Effects of Conservative Interventions on Static and Dynamic Balance in Individuals With Chronic Ankle Instability: A Systematic Review and Meta-analysis.

OBJECTIVE: To determine which conservative interventions are effective for static and dynamic balance in patients with chronic ankle instability (CAI). DATA SOURCES: PubMed, Cochrane Library, Web of Sciences, and CINAHL databases were searched up to March 20, 2022. STUDY SELECTION: Randomized controlled trials investigating the effects of conservative interventions on static and/or dynamic balance in patients with CAI compared with those of different conservative interventions or controls were included. DATA EXTRACTION: Two independent reviewers extracted the data. Certainty of the evidence was assessed using the GRADE approach. DATA SYNTHESIS: Forty-eight studies (1906 participants) were included. Whole-body vibration training (WBVT) was significantly more effective than controls for both static (standardized mean difference, 1.13; 95% confidence interval [CI], 0.58-1.68; moderate-certainty evidence) and dynamic balance (0.56; CI, 0.24-0.88; low-certainty evidence). Balance training (BT) and joint mobilization were significantly more effective than controls for dynamic balance (0.77; CI, 0.41-1.14; and 0.75; CI, 0.35-1.14, respectively), but not for static balance (very low to low-certainty evidence). Adding other interventions to BT had no significant effect on either type of balance compared with that of BT alone (moderate to low-certainty evidence). Strength training (ST) and taping had no significant effect on either type of balance (very low- to low-certainty evidence). Multimodal interventions were significantly effective in improving dynamic balance (0.76; CI, 0.32-1.20; low-certainty evidence). Adding transcranial direct current stimulation to ST was significantly more effective for dynamic balance than ST (0.81; CI, 0.08-1.53; moderate-certainty evidence). The effects on balance were not significantly different among BT, ST, and WBVT (very low- to low-certainty evidence). CONCLUSIONS: The significantly effective interventions reviewed may be treatment options for balance impairments associated with CAI. However, interventions should be chosen carefully, as much of the certainty of evidence is very low to low.

Clinical observation of contralateral needling combined with Maitland ankle mobilization for chronic ankle sprain / 针灸推拿医学（英文版）

Objective: To observe the efficacy of contralateral needling combined with Maitland ankle mobilization in the treatment of chronic ankle sprain.Methods: A total of 106 patients with chronic ankle sprain were included in the study. They were numbered according to their order of visit, with odd numbers assigned to the control group and even numbers assigned to the observation group, with 53 cases in each group. Patients in the control group were treated with Maitland ankle mobilization, while those in the observation group were given additional contralateral needling treatment. After treatment, we observed the indicators including, ankle circumference, range of motion (ROM) of dorsiflexion, ROM of plantar flexion, thickness of ankle ligaments, and the changes in Baird-Jackson ankle score, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, and visual analog scale (VAS) score to compare the efficacy between the two groups. Results: After treatment, the total effective rate of the observation group was 94.3％ and was significantly higher than that of the control group (81.1％), indicating statistical significance (P<0.05). After treatment, the ankle circumference of both groups decreased, and the ROM of dorsiflexion and the ROM of plantar flexion increased (P<0.05). The changes in the observation group were more significant, indicating inter-group statistical significance (P<0.05). After treatment, the thickness of the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament, as well as the VAS scores decreased in both groups; the changes in the observation group were more significant, indicating inter-group statistical significance (P<0.05). After treatment, the Baird-Jackson ankle score and the AOFAS ankle- hindfoot score increased in both groups, and the scores in the observation group were higher than those in the control group, indicating inter-group statistical significance (P<0.05). Conclusion: The efficacy of contralateral needling combined with Maitland ankle mobilization in the treatment of chronic ankle sprain is superior to that of Maitland ankle mobilization alone.

Acute ankle injuries: association between sprain severity and ancillary findings

ABSTRACT Objective To correlate the significance of osseous, chondral, tendon, and ligamentous injuries with anatomical variations in low-grade versus high-grade acute ankle sprains. Methods We retrospectively identified the magnetic resonance imaging findings of acute ankle sprains (<15 days). Participants with a history of previous sprains, arthritis, tumors, infections, or inflammatory conditions were excluded. Images were independently evaluated by two musculoskeletal radiologists and assessed for osseous, chondral, tendon, and ligamentous injuries and anatomical variations. Participants were divided into low-grade versus high-grade sprain groups, according to the presence of a complete tear in at least one component of the lateral ligament complex. Results The final study group comprised 100 magnetic resonance images (mean age, 36 years), the majority of males (54%), the right ankle (52%), and a mean sprain duration of 5 days. Participants with high-grade sprains presented with increased rates of medial malleolus edema (p<0.001), moderate and large articular effusions (p=0.041), and shorter calcaneonavicular distance (p=0.008). Complete tears of the anterior talofibular ligament and calcaneofibular ligaments were observed in 100% and 51.2% of the participants in the High-Grade Group, respectively. The deltoid ligament complex was partially torn in this group (55.8% versus 8.8%, p<0.001). Extensor tendon retinaculum lesions occurred significantly more frequently in this group (41.9%) compared to the overall study population (23%) (p<0.001). Conclusion Participants with high-grade ankle sprains presented with shorter calcaneonavicular distances and increased rates of medial malleolus edema, deltoid complex partial tears, extensor retinaculum lesions, and articular effusion.

Comparative analysis of the effectiveness of clinical data collection through online and physical electronic questionnaire in orthopedic patients / Análise comparativa da efetividade da coleta de dados clínicos por meio de questionários eletrônicos online e físicos em pacientes ortopédicos

ABSTRACT The collection of clinical data is an essential step for the development of any scientific research. Online digital data collection can optimize this step. Objective: To compare the response rate and the accuracy of the clinical data collection date through the online and physical digital questionnaire in orthopedic patients. Methods: Comparative study, level III of evidence, with forty patients who had ankle sprains were evaluated, followed up for a period of 12 weeks with the application of physical and digital Visual Analogue Scale, Foot Function Index and Cumberland Ankle Instability Tool questionnaires, and data were collected about the moment of collection of each questionnaire. Results: We obtained a response rate of 83.3% in the digital collection group and 60% in the physical collection group (p < 0.05), and the response rate in the digital collection group was higher at all times of collection (3, 6 and 12 weeks). Analysis of the time of collection shows greater variability in the larger physical collection group at all times of the study (2.8 vs 1.5; 4.0 vs 2.4; 8.6 vs 1.5). Conclusion: Digital data collection is effective for obtaining clinical data in patients with ankle sprains. Level of Evidence III, Comparative, Prospective, Longitudinal Study in Parallel Groups.

RESUMO A coleta de dados clínicos é etapa essencial para o desenvolvimento de qualquer pesquisa científica, e a coleta de dados digital online pode otimizá-la. Objetivo: Comparar o índice de resposta e a precisão da data de coleta de dados clínicos por meio de aplicação de questionário digital online e físico a pacientes ortopédicos. Métodos: Estudo comparativo realizado com 40 pacientes que apresentaram entorse de tornozelo, acompanhados pelo período de 12 semanas, com aplicação dos questionários escala visual analógica, foot function index e Cumberland ankle instability tool físicos e digitais. Além disso, foram recolhidos dados sobre o momento da coleta dos questionários. Resultados: Obtivemos índice de resposta de 83,3% no grupo de coleta digital e 60% no grupo de coleta física (p < 0,05), sendo que o índice de resposta no grupo de coleta digital foi maior em todos os momentos de coleta (3, 6 e 12 semanas). A análise do momento da coleta apresenta maior variabilidade no grupo de coleta física em todos os momentos do estudo (2,8 vs 1,5; 4,0 vs 2,4; 8,6 vs 1,5). Conclusão: A coleta de dados digital é efetiva para a obtenção dos dados clínicos de pacientes que apresentam entorse do tornozelo. Nível de Evidência III, Estudo Comparativo, Prospectivo, Longitudinal em Grupos Paralelos.

Ankle Sprain in Young Athletes: A 2-Year Retrospective Study at a Multisport Club.

Objective The present study aimed to analyze ankle sprains in young athletes of basketball, futsal, artistic gymnastics, trampoline, tennis, judo, and volleyball over 2 seasons. Methods Data of 529 athletes in the 1 st year and of 495 athletes in the 2 nd year of analysis were investigated from the injury record database of a sports club. The following data were considered: the demographic characteristics (age, body mass, height, and sex), the mechanism (contact or noncontact), the severity, the moment at which the injury occurred, and the recurrence. Also, the incidence rate, the injury risk of the first ankle sprain, and the incidence rate ratio between sports were calculated. Results The athletes sustained 124 ankle sprains in the 2 years of analysis. The majority occurred during training (76.6%) and lead to absence from sports practice (75.8%). The injury recurrence was low: 2 athletes (1.6%) had a recurrence in the same year and 5 (4.0%) in the following year. The incidence rate (0.79 to 12.81 per 1,000 hours) and the injury risk (1.14 to 19.44%) varied among sports. Volleyball, basketball, and futsal presented the highest injury rate incidence. Tennis, gymnastics, and trampoline showed the lowest injury rate incidence. Judo showed an incidence rate different from those of basketball and volleyball in the 1 st year and similar to those of other sports in the 2 nd year. Conclusion Ankle sprain greatly impacted sports practice and presented characteristics that differ among the investigated sports. These findings may contribute to developing preventive injury programs.

A New Zealand regional work-related sprains and strains surveillance, management and prevention programme: study protocol.

BACKGROUND: The impact and costs associated with work-related sprains and strains in New Zealand and globally are substantial and a major occupational and public health burden. In New Zealand around one-third of all sprains and strains workers compensation (ACC) claims (2019) are for back injuries, but shoulder and arm injuries are increasing at a faster rate than other sprain and strain injuries (ACC, 2020). A need exists for a change to current approaches to sprains and strains prevention, to more effectively manage this significant and persistent problem in workplaces. Designing out hazards is one of the most effective means of preventing occupational injuries and illnesses. This paper outlines the study protocol of the surveillance, management and prevention programme and describes the utilisation of prevention through design principles in the prevention of work-related sprains and strains in agriculture/horticulture/food production in the Hawkes Bay region of New Zealand. METHODS: This is a prospective mixed methods study incorporating the collection of quantitative data to describe the epidemiology of work related sprains and strains injuries presenting to the regional health centre (Hastings Health Centre) over a period of 24 months and qualitative data from participants presenting at the health centre to identify high risk industry sectors/ occupations/ workplaces and tasks and design, develop and apply prevention through design principles/ solutions/interventions to critical features of the work and work environment and undertake an outcome evaluation during the last 6 months of the project. DISCUSSION: The purpose of this project is to establish an epidemiological surveillance programme to assess the incidence and prevalence of work-related sprains and strains according to age, sex, industry sector and occupation to target efforts to prevent work-related sprains and strains, by applying prevention through design (PtD) principles in selected workplaces in agriculture. The collection of more detailed case, occupational and work history data from a sample of patients presenting at the HHC clinic will identify high risk industry sectors/occupations/workplaces and tasks. Assessment techniques will include comprehensive design, design thinking and human factors/ergonomics methodologies through co-design and participatory ergonomics techniques. The PtD solutions/ interventions implemented will be evaluated using a quasi-experimental design consisting of a pre-test/ post-test with-in subjects design with control groups that do not receive the intervention.

Ankle Sprain in Young Athletes: A 2-Year Retrospective Study at a Multisport Club / Entorse no tornozelo em jovens atletas: Um estudo retrospectivo de 2 anos em um clube multiesportivo

Abstract Objective The present study aimed to analyze ankle sprains in young athletes of basketball, futsal, artistic gymnastics, trampoline, tennis, judo, and volleyball over 2 seasons. Methods Data of 529 athletes in the 1st year and of 495 athletes in the 2nd year of analysis were investigated from the injury record database of a sports club. The following data were considered: the demographic characteristics (age, body mass, height, and sex), the mechanism (contact or noncontact), the severity, the moment at which the injury occurred, and the recurrence. Also, the incidence rate, the injury risk of the first ankle sprain, and the incidence rate ratio between sports were calculated. Results The athletes sustained 124 ankle sprains in the 2 years of analysis. The majority occurred during training (76.6%) and lead to absence from sports practice (75.8%). The injury recurrence was low: 2 athletes (1.6%) had a recurrence in the same year and 5 (4.0%) in the following year. The incidence rate (0.79 to 12.81 per 1,000 hours) and the injury risk (1.14 to 19.44%) varied among sports. Volleyball, basketball, and futsal presented the highest injury rate incidence. Tennis, gymnastics, and trampoline showed the lowest injury rate incidence. Judo showed an incidence rate different from those of basketball and volleyball in the 1st year and similar to those of other sports in the 2nd year. Conclusion Ankle sprain greatly impacted sports practice and presented characteristics that differ among the investigated sports. These findings may contribute to developing preventive injury programs.

Resumo Objetivo O presente estudo teve como objetivo analisar entorses no tornozelo em jovens atletas de basquete, futsal, ginástica artística, trampolim, tênis, judô e vôlei ao longo de duas temporadas. Métodos Foram investigados dados de 529 atletas no 1° ano e 495 atletas no 2° ano de análise a partir do banco de dados de registros de lesões de um clube esportivo. Foram considerados os seguintes dados: as características demográficas (idade, massa corporal, altura e sexo), o mecanismo (contato ou não contato), a severidade, o momento em que ocorreu a lesão e a recorrência. Além disso, foram calculadas a taxa de incidência, o risco de lesão da primeira entorse no tornozelo e a razão da taxa de incidência entre os esportes. Resultados Os atletas sofreram 124 entorses no tornozelo nos 2 anos de análise. A maioria ocorreu durante o treinamento (76,6%) e levou à interrupção da prática esportiva (75,8%). A recorrência da lesão foi baixa: 2 atletas (1,6%) tiveram recorrência no mesmo ano e 5 (4,0%) no ano seguinte. A taxa de incidência (0,79 a 12,81 por 1.000 horas) e o risco de lesão (1,14 a 19,44%) variaram entre os esportes. Vôlei, basquete e futsal apresentaram a maior incidência de lesões. Tênis, ginástica e trampolim apresentaram a menor incidência de lesões. O judô apresentou uma taxa de incidência diferente das do basquete e do vôlei no 1° ano e semelhante às dos outros esportes no 2° ano. Conclusão A entorse no tornozelo impactou muito a prática esportiva e apresentou características que diferem entre os esportes investigados. Esses achados podem contribuir para o desenvolvimento de programas de prevenção de lesões.

Avascular Necrosis of the Talus Following Subchondroplasty: A Case Report and Review of Literature.

CASE: Avascular necrosis (AVN) of the talus in a 45-year-old female following subchondroplasty with calcium phosphate bone filler for treatment of anterolateral and posteromedial talar dome bone marrow lesions (BMLs). The patient subsequently presented as consultation, 18 months postoperatively, with AVN of the talus. After failing conservative management, the patient underwent a total ankle arthroplasty at 46 months after subchondroplasty with resolution of pain. CONCLUSION: There are few studies that have reported on the safety of subchondroplasty of the talus. Given the tenuous blood supply to the talar body and poor patient outcomes associated with AVN, caution should be taken before extrapolating the generally positive results of subchondroplasty in the knee. LEVEL OF EVIDENCE: Level IV.

Injury and Illness Incidence in 2017 Super Rugby Tournament: A Surveillance Study on a Single South African Team.

Background: Professional rugby presents significant injury and illness risks to players, which need to be regularly assessed to monitor the effects of interventions and competition rules changes. Hypothesis/Purpose: The purpose of this study was to determine the incidence and nature of time-loss injuries and illness during the pre-season and competition period of the 2017 Super Rugby tournament in a single South African team. Study Design: Descriptive Epidemiology Study. Methods: Forty-five adult players were recruited from one 2017 Super Rugby South African team, with 39 included in the final data set. Daily injury and illness data were routinely collected during the season by support staff over a 28-week period (January to July 2017), based on standardized injury and illness definitions. Retrospective analyses of the data were performed. Results: The incidence of match injuries (241.0 per 1000 player hours) was significantly higher than training injuries (3.3 per 1000 player hours). Twenty one percent of all injuries occurred during the tackle; 37.5% of all injuries were of a "moderate" severity. The proportion of players who sustained a time-loss injury was 76.9% (n=30). The overall incidence of illness was 1.8 per 1000 player days. Acute respiratory tract infection (28.6%) was the most common diagnosis, and the majority of illnesses (64.3%) did not result in time-loss. Conclusion: This study presented a longer study period than previous research by including the pre-season training, but represented only one single team. The incidence of match injuries was significantly higher than previously reported in Super Rugby tournaments, whereas illness rates were significantly lower. Support staff in professional rugby need to be trained on the standardized Orchard System of Classifications to ensure good quality data that can be compared to other teams within the same or other sporting codes. Level of evidence: Level 3.

What have we learnt from quantitative case reports of acute lateral ankle sprains injuries and episodes of 'giving-way' of the ankle joint, and what shall we further investigate?

Lateral ankle sprains are a commonly incurred injury in sports. They have a high recurrence rate and can lead to the development of persistent injury associated symptoms. We performed a quantitative synthesis of published case reports documenting the kinematics of acute lateral ankle sprains and episodes of 'giving-way' of the ankle joint to provide a comprehensive description of the mechanisms. A systematic literature search was conducted to screen records within MEDLINE® and EMBASE®. Additional strategies included manual search of specific journals, as well as contacting researchers in relevant communities to retrieve unpublished data. Twenty-four cases were included in the quantitative synthesis, 11 from individual case reports and 13 from four separate case series. Two authors independently reviewed all the articles and extracted ankle joint kinematic data. Excessive ankle inversion was the most pronounced kinematic pattern observed across all included cases, with a mean peak inversion angle of 67.5° (range 2.0 to 142) and a mean peak inversion velocity of 974°/s (range 468 to 1752). This was followed by internal rotation and plantar flexion, respectively. A homogeneous linear function revealed a mean inversion velocity across all cases of 337°/s (range 117 to 1400; R2 = 0.78; p < 0.0001).

Clinical effect of foot-ankle balance massage combined with herbal fumigation in the treatment of acute ankle sprain / 国际中医中药杂志

Objective:To explore the clinical curative effect of foot-ankle balance massage combined with herbal fumigation on acute ankle sprain.Methods:According to random number table method, 62 patients with acute ankle sprain meeting the inclusion criteria in the hospital were divided into control group and observation group between January 2018 and January 2021, 31 in each group. The control group was treated with foot-ankle balance massage, while the observation group added herbal fumigation treatment on the basis of the control group treatment. Both were treated for 7 days. The pain degree was evaluated by Visual Analogue Scale (VAS). The pain sites of ankle joint were evaluated by Kofoed ankle scale. The recovery of ankle and foot function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS). The levels of plasma substance P, neuropeptide, nerve growth factor (NGF), IL-1β, IL-6 and hs-CRP were detected by enzyme-linked immunosorbent assay. The clinical curative effect was assessed.Results:The differences in total response rate between observation group and control group were statistically significant [96.8% (30/31) vs. 77.4% (24/31)] ( χ 2=5.17, P=0.023). At 1st day, 3rd day and 7th day after treatment, VAS scores in observation group were significantly lower than those in the control group ( t=4.86, 5.19, 3.86, P<0.01), Kofoed scores were significantly higher than those in the control group ( t=2.03, 2.58, 2.46, P<0.05), and AOFAS pain scores were significantly higher than those in the control group ( t=2.61, 2.47, 4.90, P<0.05). After treatment, levels of substance P [(2.94±0.91) mg/L vs. (3.69±0.94) mg/L, t=3.19], neuropeptide [(141.06±16.31) ng/L vs. (165.22±17.63) ng/L, t=3.16] and NGF [(43.65±10.15) ng/L vs. (52.26±10.20) ng/L, t=3.33] in observation group were significantly lower than those in the control group ( P<0.01), and levels of IL-1β, IL-6 and hs-CRP were significantly lower than those in the control group ( t=2.60, 2.64, 2.42, P<0.05). Conclusion:The foot-ankle balance massage combined with herbal fumigation can quickly relieve pain, increase levels of pain substances, reduce levels of inflammatory cytokines and improve curative effect in patients with acute ankle sprains.