Abstract
The objective of this retrospective case study was to describe the incidence and clinical
features of severe open ankle sprain (SOAS), defined as a tear of the lateral or medial
collateral ligaments with an associated transverse tear of the skin over the corresponding
malleolus. To this end, we reviewed the medical records of patients with SOAS managed
between January 2005 and January 2009, using the databases of 3 different orthopedic
trauma centers. Our review revealed 9 patients with SOAS, 7 (77.77%) of which involved
the lateral ligaments and 2 (22.22%) of which involved the medial ligaments. The median
age was 32 (range 21 to 45) years, and the injury occurred as a result of a motor
vehicle accident in 6 (66.67%) patients, and as a result of a fall from a height in
3 (33.33%) patients. Two tendons were damaged in 2 (22.22%) patients, the deep fibular
nerve (deep peroneal nerve) in 2 (22.22%) patients, and the anterior tibial artery
in 1 (11.11%) patient. The only abnormality on plain radiographs was pneumarthrosis,
which was present in 5 (55.56%) patients. The incidence of SOAS is rare, accounting
for 0.002% (9/438,000) of all trauma cases and 0.22% (9/4142) of all cases of ankle
trauma. The diagnosis was confirmed by intraoperative stress-maneuvers in all 9 patients.
In conclusion, SOAS should be suspected in patients who present with a traumatic skin
wound over the malleolus.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
