Sprained ankle in children. A clinical follow-up study of 90 children treated conservatively and by surgery.

The study concerns 90 ankle injuries with lateral sprains, in children aged 5 to 14 years. 50 ankles treated non-operatively during 1978 were examined clinically and radiologically 14 to 24 months (mean 18 months) after the injury. Those patients who still had complaints were examined by questionnaire in October 1982, about four years after the injury. 21 patients (42%) had symptoms of disability at the first follow-up examination, and in 4 of these 21 ankles had to be operated on later because of functional instability and pain. Five others which had been treated conservatively, continued to have symptoms of functional instability four years after the injury, whereas the other 12 had healed and were symptomless. In 40 acutely injured ankles, surgery revealed an avulsion fragment in 19, and an isolated rupture of the anterior talo-fibular ligament without any lesion of the bone or cartilage in another 17. Ankles treated operatively healed well and the patients were symptom free at follow-up 6 to 21 months (mean 9 months) postoperatively. Our results suggest that lesions of the anterior talo-fibular ligament are surprisingly common in children. Primary repair of the ligament will ensure a symptomless and stable ankle joint.