Incidence and Determinants of Recurrent Lateral Ankle Ligamentous Sprain

Objective: Little is known about the incidence and determinants of recurrent acute lateral ankle ligamentous sprain (ALALS) in the general population. Our purpose was to determine the proportion of patients suffering from recurrent ALALS during one year follow-up after the initial injury and to identify risk factors for sustaining a recurrent ALALS. Design: Prospective cohort study. Setting: Patients were recruited from 20 family practices, nine physical therapy practices and emergency departments of two hospitals. Subjects: Adult patients with an ALALS caused by inversion trauma. Methods: Univariable and multivariable Cox regression analysis. Results: After 52 weeks follow-up, 29 of the 157 patients (18%; 95% CI 12.4- 24.5) had experienced an ALALS. Univariable analysis showed that younger age, a lower BMI, having had more than one ankle injury, sports participation and the number of hours of sports per week was associated with the risk of recurrent ALALS. Multivariable analysis showed that with increasing age the risk to suffer an ALALS decreases (HR 0.92 (95% CI 0.87-0.98). Conclusions: Nearly one fifth of the patients with ALALS suffer from a re-injury within 12 months and the injury risk decreases with increasing age. This highlights the importance of optimal treatment and preventive programs in younger adults.