scholarly journals Evaluation of foot and ankle injuries in professional soccer

2020 ◽  
Vol 14 (2) ◽  
pp. 158-162
Author(s):  
Danilo Pizzo Kitagaki ◽  
Eduardo Souza Maciel ◽  
Nacime Salomão Barbachan Mansur ◽  
Eduardo Ramalho De Moraes ◽  
Gustavo Gonçalves Arliani
Keyword(s):  
Triceps Surae ◽  
Physical Contact ◽  
Ankle Injuries ◽  
Ankle Sprains ◽  
X Rays ◽  
Foot And Ankle ◽  
Time Loss ◽  
Lateral Ankle ◽  
Professional Soccer

Objective: To evaluate the profile of foot and ankle injuries in professional soccer. Methods: Data were collected prospectively during the 2016 São Paulo Soccer Championship using two electronic forms: an initial form (10 variables) and a follow-up form (6 variables). The results were standardized and evaluated in SPSS 23.0. Results: A total of 259 injuries were reported: 106 to the thigh (40.9%), 42 to the foot and ankle (16.2%), 39 to the knee (15.1%), 39 to the head or face (15.1%) and 33 in other locations (12.7%). Of the 42 foot and ankle injuries, 20 were lateral ankle sprains (47.6%), 5 were medial ankle sprains (11.9%), 3 were to the triceps surae (7.1%), 3 were leg contusions (7.1%), 3 were foot contusions (7.1%), 2 were myalgias (4.8%), in addition to 5 other types (11.9%). There was physical contact in 73.8% of the injuries (p <0.001), and six injuries (14.3%) were considered severe, i.e., involving a time loss of at least one month. Of the severe injuries, four were treated surgically (three by osteosynthesis and one by tenorrhaphy). The mean time loss due to injury was 19.7 days, and the overall incidence rate was 3.5 injuries per 1000 hours of exposure, with 2.1 ligament injuries per 1000 hours. X-rays and magnetic resonance imaging were the most requested tests in the follow-up of these patients. Conclusion: Foot and ankle injuries were the second most frequent injury in Brazilian professional soccer, 73.8% of which resulted from physical contact (p<0.001). Lateral ankle sprains accounted for 47.6% of these injuries, which reaffirms their high prevalence and importance for sports medicine. Level of Evidence III; Prognostic Studies; Prospective Study.

scholarly journals Epidemiology of Foot and Ankle Injuries in National Collegiate Athletic Association Men’s and Women’s Ice Hockey

2019 ◽  
Vol 7 (8) ◽  
pp. 232596711986590 ◽  
Author(s):  
Steven G. Crowley ◽  
David P. Trofa ◽  
J. Turner Vosseller ◽  
Prakash Gorroochurn ◽  
Lauren H. Redler ◽  
...  
Keyword(s):  
National Collegiate Athletic Association ◽  
Injury Surveillance ◽  
Ice Hockey ◽  
Ankle Injuries ◽  
Surveillance Program ◽  
Ankle Sprains ◽  
Foot And Ankle ◽  
Time Loss ◽  
Injury Rates ◽  
Hockey Players

Background: Ice hockey is a high-speed contact sport in which athletes are prone to many different injuries. While past studies have examined overall injury rates in ice hockey, foot and ankle injuries among collegiate ice hockey players have yet to be analyzed. Purpose/Hypothesis: The purpose of this study was to elucidate the epidemiology of foot and ankle injuries among collegiate ice hockey players utilizing data from the National Collegiate Athletic Association (NCAA) Injury Surveillance Program. We hypothesized that male ice hockey players would sustain more injuries compared with female ice hockey players and that the injuries sustained would be more severe. Study Design: Descriptive epidemiology study. Methods: Data on all foot and ankle injuries sustained during the academic years 2004 through 2014 were obtained from the NCAA Injury Surveillance Program. Injury rates, rate ratios (RRs), and injury proportion ratios were reported with 95% CIs. Results: Over the study period, the overall rate of foot and ankle injuries for men was higher than that for women (413 vs 103 injuries, respectively; RR, 4.01 [95% CI, 3.23-4.97]). Injury rates were highest during the regular season for both men (358 injuries; RR, 64.78 [95% CI, 58.07-71.49]) and women (89 injuries; RR, 38.37 [95% CI, 30.40-46.35]) compared with the preseason or postseason. The most common injury in men was a foot and/or toe contusion (22.5%), while women most commonly sustained a low ankle sprain (31.1%). For men, foot and/or toe contusions accounted for the most non–time loss (≤24 hours ) and moderate time-loss (2-13 days) injuries, while high ankle sprains accounted for the most severe time-loss (≥14 days) injuries. For women, foot and/or toe contusions accounted for the most non–time loss injuries, low ankle sprains accounted for the most moderate time-loss injuries, and high ankle sprains accounted for the most severe time-loss injuries. Conclusion: Foot and ankle injuries were frequent among collegiate ice hockey players during the period studied. For men, contusions were the most commonly diagnosed injury, although high ankle sprains resulted in the most significant time lost. For women, low ankle sprains were the most common and resulted in the most moderate time lost. These findings may direct future injury prevention and guide improvements in ice skate design.

Evaluation of the Sports Ankle Rating System in Young, Athletic Individuals with Acute Lateral Ankle Sprains

2003 ◽  
Vol 24 (3) ◽  
pp. 274-282 ◽  
Author(s):  
Glenn N. Williams ◽  
Joseph M. Molloy ◽  
Thomas M. DeBerardino ◽  
Robert A. Arciero ◽  
Dean C. Taylor
Keyword(s):  
Ankle Injuries ◽  
Rating System ◽  
Ankle Sprains ◽  
Rating Score ◽  
Lateral Ankle ◽  
Life Measure ◽  
Initial Validation ◽  
Unique System ◽  
The Impact

The purpose of this paper is to introduce the Sports Ankle Rating System and provide the initial validation for its use. As its name implies, this outcomes measurement system is intended for use in assessing the functional outcomes of athletes with ankle injuries. This unique system consists of three distinct instruments: the Quality of Life Measure, the Clinical Rating Score, and the Single Assessment Numeric Evaluation. We began the validation process of the Sports Ankle Rating System with subjects who had sustained lateral ankle sprains because this is the most common injury in sports. The results of this study indicate that the Sports Ankle Rating System is: effective at assessing the impact that an ankle sprain has on an athlete's functional and psychosocial status responsive to changes in an athlete's ankle-related health status, and valid and reliable as tested.

The Snowboarder's Foot and Ankle

1998 ◽  
Vol 26 (2) ◽  
pp. 271-277 ◽  
Author(s):  
Douglas P. Kirkpatrick ◽  
Robert E. Hunter ◽  
Peter C. Janes ◽  
Jackie Mastrangelo ◽  
Richard A. Nicholas
Keyword(s):  
Injury Rate ◽  
Soft Tissue Injuries ◽  
Fracture Pattern ◽  
Ankle Injuries ◽  
Anterior Talofibular Ligament ◽  
Ankle Sprains ◽  
Foot And Ankle ◽  
Foot Injuries ◽  
Lateral Process ◽  
Ski Resorts

We undertook a prospective study to determine the type and distribution of foot and ankle snowboarding injuries. Reports of 3213 snowboarding injuries were collected from 12 Colorado ski resorts between 1988 and 1995. Of these, 491 (15.3%) were ankle injuries and 58 (1.8%) were foot injuries. Ankle injuries included 216 (44%) fractures and 255 (52%) sprains. Thirty-three (57%) of the foot injuries were fractures and 16 (28%) were sprains. The remaining injuries were soft tissue injuries, contusions, or abrasions. There was no significant correlation between boot type (soft, hybrid, or hard) and overall foot or ankle injury rate. There were significantly fewer ankle sprains in patients wearing hybrid boots and fewer fractures of the lateral process of the talus in patients wearing soft boots. An unexpectedly high number of fractures of the lateral process of the talus were noted. These 74 fractures represented 2.3% of all snowboarding injuries, 15% of all ankle injuries, and 34% of the ankle fractures. Many of these fractures are not visible on plain radiographs and require computed tomography imaging to be diagnosed. Diagnosis of this fracture pattern is paramount; the physician should be very suspicious of anterolateral ankle pain in the snowboarder, where subtle fractures that may require surgical intervention can be confused with anterior talofibular ligament sprains.

Free Flap Reconstruction of Traumatic Pediatric Foot and Ankle Defects: An Analysis of Clinical and Functional Outcomes

2021 ◽  
Author(s):  
Rajiv P. Parikh ◽  
Austin Ha ◽  
Thomas Tung
Keyword(s):  
Limb Salvage ◽  
Functional Outcomes ◽  
Free Flaps ◽  
Ankle Injuries ◽  
Foot And Ankle ◽  
Fasciocutaneous Flaps ◽  
Muscle Flaps ◽  
Microsurgical Reconstruction ◽  
Pediatric Foot

Abstract Background Traumatic lower extremity injuries involving the foot and ankle can have devastating consequences and represent a complex reconstructive challenge. To date, there are limited reports on microsurgical reconstruction for foot and ankle defects in children. This study aims to evaluate clinical and functional outcomes of free flaps for pediatric foot and ankle injuries. Methods This is a retrospective review of patients undergoing free flaps for traumatic foot and ankle defects at a pediatric trauma center between 2000 and 2015. Patients with less than 5-year follow-up were excluded. Demographics, clinical characteristics, and postoperative outcomes were evaluated. Results Thirty patients undergoing 30 flaps were analyzed. The mean age was 11.9 years (range: 2 to 17 years). Muscle flaps (n = 21, 70%) were more common than fasciocutaneous flaps (n = 9, 30%). Limb salvage with functional ambulation was achieved in 96.7% of patients (n = 29). The complication rate was 33.3% (n = 10), with wound breakdown (n = 6, 20.0%) as most common feature. There were no significant differences in limb salvage, total or partial flap loss, fracture union, and donor-site complications based on flap type. Fasciocutaneous flaps were more likely to require revision procedures for contour compared with muscle flaps (55.6 vs. 9.5%, p = 0.013). Mean follow-up was 8.5 years. Conclusion Microsurgical reconstruction of pediatric foot and ankle defects results in high rates of limb salvage. A defect- and patient-centered approach to reconstruction, emphasizing durable coverage and contour, is critical to facilitating ambulation and ensuring favorable long-term functional outcomes.

scholarly journals Obesity as a Risk Factor for Failure following a Modified Brostrom Procedure

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0003
Author(s):  
Daniel Corr ◽  
Ryan G. Rogero ◽  
Justin E. Palm ◽  
Joseph N. Daniel ◽  
Steven M. Raikin ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Postoperative Period ◽  
Ankle Instability ◽  
Clinical Success ◽  
Treatment Success ◽  
Foot And Ankle ◽  
Lateral Ankle ◽  
Lateral Ankle Instability ◽  
Modified Broström Procedure

Category: Ankle; Hindfoot Introduction/Purpose: The modified Brostrom procedure has been widely accepted as the operative treatment of choice for treating lateral ankle instability in patients that have failed nonoperative management. However, the predisposing risk factors for failure of operative treatment, which has important implications for patient selection, is unknown. Foot and ankle surgeons often raise body mass index (BMI) as a particular concern due to the increased pressure and strain that is applied to the repair with standing and walking in the setting of an elevated BMI. The purpose of this study was to investigate the effect of patient BMI at the time of surgical intervention on preoperative and long-term postoperative functional outcomes, as well as complication and reoperation rates. Methods: A retrospective single institutional study of 160 modified Brostrom procedures, average age 43.8 years, was performed with a minimum of 2-year follow-up. An electronic query based on Current Procedural Terminology codes was initially performed followed by a manual review of the operative report. Patients with any concurrent osteotomy, arthrodesis, or arthroplasty procedures were excluded. Pre- and postoperative Foot and Ankle Ability Measure (FAAM) ADL and Sports survey responses along with Visual Analog Scale for Pain (0-100) patient reports were recorded. Comorbidities and relevant demographic information were manually obtained. Patients were split into two groups based on their preoperative BMI: those patients with BMI <30 and those >=30 (considered obese). Treatment success was defined as achieving the previously established minimal clinically important difference (MCID) FAAM-ADL increase of >=8 and/or FAAM-Sport increase of >=9 from the preoperative to postoperative period. Results: Of 97 patients with BMI <30, 22 (22.7%) did not demonstrate a self-reported MCID in the FAAM-ADL score, and 20 (20.6%) did not demonstrate positive MCID in the FAAM-Sport score. For the 63 patients with BMI >=30, 13 (20.6%) failed to reach FAAM-ADL MCID, while 12 (19%) failed to reach FAAM-Sport MCID. BMI was not shown to be significant in terms of clinical improvement following surgery, as both groups improved significantly on average from preoperative period to follow-up with 125/160 (78.1%) achieving MCID in FAAM-ADL and 128/160 (80%) achieving MCID in FAAM-Sport. However, patients with BMI <30 had significantly higher average preoperative FAAM-ADL scores than those >=30 (66.7 vs 51.2; p=0.003) and higher average postoperative ADL scores that approached significance (92.9 vs 84.5; p=0.075). Conclusion: The modified Brostrom procedure has been previously shown to effectively improve stability and function of the ankle with relatively high rates of success, and such findings are supported by this study. In addition, this study demonstrates that patient BMI is not a prohibitive factor in limiting clinical success in the postoperative period. The procedure was generally effective for both groups of patients. However, data suggests that the condition of lateral ankle instability may simply be more debilitating for those patients with obese BMI, and that these patients should have lower expectations in terms of their absolute recovery of function. [Table: see text]

scholarly journals Functional outcomes and return-to-sports rate after modified Brostrom repair for lateral ankle instability with absorbable sutures and immediate postoperative weightbearing

2017 ◽  
Vol 2 (2) ◽  
pp. 2473011416S0000 ◽  
Author(s):  
Somen Agrawal ◽  
Greg Keene ◽  
James Clayton
Keyword(s):  
Functional Outcomes ◽  
Ankle Instability ◽  
Weight Bearing ◽  
Return To Sport ◽  
Cost Effective ◽  
Foot And Ankle ◽  
Lateral Ankle ◽  
Absorbable Sutures ◽  
Lateral Ankle Instability

Category: Sports Introduction/Purpose: The ankle is commonly injured in sporting activities occurring in up to 1 in 10,000 people a day. About 80% of ankle sprains recover with nonoperative management, with the remaining 20% of patients developing symptomatic instability requiring surgery. There are various surgical options being used, including anatomic repair (Brostrom technique and modifications), anatomic recon- struction with autograft or allograft, and nonanatomic reconstructions such as the Watson-Jones, Evans, and Chrisman-Snook procedures. The outcome of the direct anatomic repair is likely dependent on tissue quality, ability to tension the ligaments, and the security of the fixation. Secure fixation is critical to enable an early rehabilitation without compromising clinical outcome. We hypothesized that using absorbable suture for anatomic reconstruction is not only cost effective but also allows early rehabilitation with immediate postoperative weightbearing with good functional outcomes. Methods: The study included 71 patients presenting with chronic lateral ankle instability (who failed non-operative management) who underwent modified Brostrom repair by a single surgeon between Jan 2012 and Feb 2014.The anterior talofibular ligament and calcaneo- fibular ligament were anatomically repaired , and the repair was augmented with inferior extensor retinaculum proximal advancement, both with 1 vicryl suture. Full weight bearing in normal shoe was allowed from the day of surgery. Physiotherapy commenced prior to discharge from day surgery with gentle active range of motion, calf strength, and static peroneii exercises. From 3 to 4 weeks proprioceptive, theraband, and dynamic peroneal exercises were started. No boots, braces, or casts were used at any stage in the post-operative period. Patients were assessed preoperatively and at a minimum 2-year follow-up using the Foot and Ankle Outcome Score (FAOS). Complication, failure (recurrent instability), and return-to-sport rates were also recorded. Results: There were 41 were males and 30 females with mean age at surgery of 27 years (range 16 - 47 years), mean duration of symptoms of 2 years (range, 6 months to 8 years)and a mean follow-up duration of 34 months (range 24- 49 months). Significant improvement was seen in the FAOS from preoperatively to postoperatively (from 37 to 79): the pain subscale , the symptom subscale, the function subscale, the function in sports and recreation subscale, and the foot and ankle–related quality of life subscale improved from 38 to 79, 42 to 81, 43 to 82 , 31 to 79 and 32 to 77 respectively. All these findings were statistically significant. The failure rate was 4%, with 3 patients reporting instability after subsequent traumatic re-rupture. Two case of temporary neuropraxia of the superficial peroneal nerve was observed. Fifty four out of 71 patients were involved in sports prior to injury and forty seven (87%) returned to sport after reconstruction. Conclusion: This study demonstrates that lateral ligament reconstruction using absorbable sutures is an effective procedure for the treatment of chronic lateral ankle instability and allows immediate weight bearing. This allows a cost-effective approach to management with minimal impact on a patient’s activities of daily living in the post-operative period. The procedure also has high return-to-sport rate.

Foot and ankle injuries and time lost from play in professional soccer players

The Foot ◽  
2009 ◽  
Vol 19 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Haluk H. Oztekin ◽  
Hakan Boya ◽  
Ozal Ozcan ◽  
Bulent Zeren ◽  
Pelin Pinar
Keyword(s):  
Ankle Injuries ◽  
Soccer Players ◽  
Foot And Ankle ◽  
Professional Soccer

scholarly journals The epidemiology, evaluation, and assessment of lateral ankle sprains in athletes

2021 ◽  
Vol 6 (2) ◽  
pp. 008-017
Author(s):  
Cavazos Jr. G Javier ◽  
Harkless Lawrence B
Keyword(s):  
Best Practice ◽  
Healthcare Providers ◽  
Treatment Strategies ◽  
The United States ◽  
Ankle Injuries ◽  
Return To Play ◽  
Medical Attention ◽  
Ankle Sprains ◽  
Lateral Ankle ◽  
True Incidence

Approximately 30,000 ankle injuries occur every day in the United States. With the incidence estimated at more than 3 million a year and at a rate of 2.15/1,000 in the U.S. alone, medical specialists and other healthcare providers caring for the foot and ankle must take notice. Despite the millions of ankle injuries sustained annually, the true incidence may be underestimated, as fewer than half of individuals with ankle sprains seek medical attention from healthcare professionals. The economic burden associated with the evaluation, diagnosis, and treatment is close to $4 billion annually. Ankle sprains account for half of all sports injuries and remains a difficult diagnostic and therapeutic challenge in the athlete. Accurate diagnosis is critical as 40% of ankle sprains are misdiagnosed or poorly treated leading to chronic ankle pain and disability. Implementing evidence supported diagnostic and treatment strategies is the goal for ensuring safe and rapid return to play. The Lateral Ankle Sprain (LAS) is among the most common type of ankle sprains suffered during athletic activities. Up to 80% of LAS are of the inversion type, and 75% lead to recurrence and instability. Although most individuals experiencing a LAS return to activity within six weeks, many report continued pain, diminished function, and instability. The purpose of this review is to highlight the epidemiology, pathoetiology, pathoanatomy, and biomechanics of the LAS, enabling sports physicians to implement the best practice guidelines and protocols to manage this common enigma.

scholarly journals The diagnostic accuracy of ultrasound in the detection of foot and ankle fractures: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Jiangfeng Wu ◽  
Yunlai Wang ◽  
Zhengping Wang
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Ankle Fractures ◽  
Ankle Injuries ◽  
Significant Heterogeneity ◽  
X Rays ◽  
Foot And Ankle

Aims: Foot and ankle injuries are a common presenting complaint in the emergency department. The diagnosis of foot and ankle fractures is conventionally accomplished through X-rays. Whether ultrasound (US) can be considered as a primary scanning modality is still a controversial issue; therefore, we did a meta-analysis to synthesize the diagnostic performance ofultrasound for foot and ankle fractures.Material and methods: A comprehensive search was carried out to identify studies in which patients with clinically suspected foot and ankle fractures were assessed by US. Two investigators independently screened the literature and extracted the data. Any discrepancies were resolved via discussion. Study quality was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool, and pooled sensitivity and specificity of various US findings were determined.Results: Ten studies with a total of 1065 patients were included. There was significant heterogeneity across the included studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for the diagnosis of foot and ankle fractures by US were 0.96 (95% confidence interval [CI], 0.90-0.99), 0.94 (95% CI, 0.88-0.97), 15.0 (95% CI, 7.9-28.6), 0.04 (95% CI, 0.02-0.11), and 367 (95% CI, 101-1338), respectively. Furthermore, the summary receiver operating characteristic area under the curve was calculated to be 0.99.Conclusions: Ultrasound has an excellent diagnostic performance for foot and ankle fractures and should be considered as a primary and radiation-free scanning modality in the diagnosis of foot and ankle fractures.

Follow-up Evaluation of Medial Clear Space and Talar Tilt After Bimalleolar Equivalent Fracture Fixation Without Primary Deltoid Repair

2021 ◽  
Vol 111 (4) ◽  
Author(s):  
Dalton Ryba ◽  
Jordan Ernst ◽  
Somer Blair ◽  
Travis A. Motley
Keyword(s):  
Ankle Fractures ◽  
Fixation Method ◽  
Foot And Ankle ◽  
Lateral Ankle ◽  
Clear Space ◽  
Outcome Score ◽  
Study Results ◽  
Perceived Outcomes ◽  
Subjective Outcomes

Background We sought first to determine the efficacy of lateral ankle fixation alone in maintenance of medial clear space and talar valgus in bimalleolar equivalent ankle fractures not receiving primary deltoid repair, and second to assess perceived outcomes via the Foot and Ankle Outcome Score. To our knowledge, no study has quantified the reduction of medial clear space and talar valgus in bimalleolar equivalent ankle fractures receiving lateral ankle fixation alone. Methods We compared preoperative, initial postoperative, and greater than 1-year follow-up radiographs of medial clear space and talar valgus in individuals who received lateral ankle fixation alone in bimalleolar equivalent ankle fractures. Subjective outcomes were measured via the Foot and Ankle Outcome Score. Results Thirty-seven patients participated in the study and showed a statistically significant reduction of medial clear space and restoration of talar position, and maintenance with this fixation method during follow-up in patients with bimalleolar equivalent ankle fractures. Adjunctively, patients perceived their outcomes to be satisfactory, as demonstrated by the results of the Foot and Ankle Outcome Score. Conclusions We aimed to assess the efficacy of lateral ankle fixation in the maintenance of medial clear space and talar valgus reduction at midterm follow-up. Although some authors contend that primary deltoid repair in bimalleolar equivalent ankle fractures is warranted, these midterm study results suggest that isolated lateral ankle fixation is adequate for medial ankle stabilization in bimalleolar equivalent fractures, and thus primary deltoid repair is not indicated.

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