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      Shapes of distal tibiofibular syndesmosis are associated with risk of recurrent lateral ankle sprains

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          Abstract

          Distal tibiofibular syndesmosis (DTS) has wide anatomic variability in depth of incisura fibularis and shape of tibial tubercles. We designed a 3-year prospective cohort study of 300 young physical training soldiers in an Army Physical Fitness School. Ankle computed tomography (CT) scans showed that 56% of the incisura fibularis were a “C” shape, 25% were a “1” shape, and 19% were a “Г” shape. Furthermore, we invited a randomly selected subcohort of 6 participants in each shape of DTS to undergo a three-dimensional (3D) laser scanning. The “1” shape group showed widest displacement range of the DTS in the y-axis, along with the range of motion (ROM) on the position more than 20° of the ankle dorsiflexion, inversion and eversion. During the 3-year study period, 23 participants experienced recurrent lateral ankle sprains. 7 cases of the incisura fibularis were “C” shape, 13 cases were “1” shape, and 3 cases were “Г” shape. The “1” shape showed highest risk among the three shapes in incident recurrent lateral ankle sprains. We propose that it is possible to classify shapes of DTS according to the shapes of incisura fibularis, and people with “1” shape may have more risk of recurrent lateral ankle sprains.

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          Ankle injuries in basketball: injury rate and risk factors.

          G McKay (2001)
          To determine the rate of ankle injury and examine risk factors of ankle injuries in mainly recreational basketball players. Injury observers sat courtside to determine the occurrence of ankle injuries in basketball. Ankle injured players and a group of non-injured basketball players completed a questionnaire. A total of 10 393 basketball participations were observed and 40 ankle injuries documented. A group of non-injured players formed the control group (n = 360). The rate of ankle injury was 3.85 per 1000 participations, with almost half (45.9%) missing one week or more of competition and the most common mechanism being landing (45%). Over half (56.8%) of the ankle injured basketball players did not seek professional treatment. Three risk factors for ankle injury were identified: (1) players with a history of ankle injury were almost five times more likely to sustain an ankle injury (odds ratio (OR) 4.94, 95% confidence interval (CI) 1.95 to 12.48); (2) players wearing shoes with air cells in the heel were 4.3 times more likely to injure an ankle than those wearing shoes without air cells (OR 4.34, 95% CI 1.51 to 12.40); (3) players who did not stretch before the game were 2.6 times more likely to injure an ankle than players who did (OR 2.62, 95% CI 1.01 to 6.34). There was also a trend toward ankle tape decreasing the risk of ankle injury in players with a history of ankle injury (p = 0.06). Ankle injuries occurred at a rate of 3.85 per 1000 participations. The three identified risk factors, and landing, should all be considered when preventive strategies for ankle injuries in basketball are being formulated.
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            An epidemiological survey on ankle sprain.

            Wallace H. L. So, Louis Chan, W Yuan … (1994)
            Ankle sprain is a common sports injury and is often regarded as trivial by athletes and coaches. This epidemiological study was conducted among three categories of Hong Kong Chinese athletes: national teams, competitive athletes and recreational athletes. This study shows that as much as 73% of all athletes had recurrent ankle sprain and 59% of these athletes had significant disability and residual symptoms which led to impairment of their athletic performance. This study indicates that a proper approach towards injury prevention and a comprehensive rehabilitation programme are required.
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              The effect of a proprioceptive balance board training program for the prevention of ankle sprains: a prospective controlled trial.

              Lex Bouter, Jos Twisk, Evert Verhagen … (2004)
              Ankle sprains are the most common injuries in a variety of sports. A proprioceptive balance board program is effective for prevention of ankle sprains in volleyball players. Prospective controlled study. There were 116 male and female volleyball teams followed prospectively during the 2001-2002 season. Teams were randomized by 4 geographical regions to an intervention group (66 teams, 641 players) and control group (50 teams, 486 players). Intervention teams followed a prescribed balance board training program; control teams followed their normal training routine. The coaches recorded exposure on a weekly basis for each player. Injuries were registered by the players within 1 week after onset. Significantly fewer ankle sprains in the intervention group were found compared to the control group (risk difference = 0.4/1000 playing hours; 95% confidence interval, 0.1-0.7). A significant reduction in ankle sprain risk was found only for players with a history of ankle sprains. The incidence of overuse knee injuries for players with history of knee injury was increased in the intervention group. History of knee injury may be a contraindication for proprioceptive balance board training. Use of proprioceptive balance board program is effective for prevention of ankle sprain recurrences.
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                Author and article information

                Contributors
                Dasheng Lin: linds@xmu.edu.cn
                Journal
                Journal ID (nlm-ta): Sci Rep
                Journal ID (iso-abbrev): Sci Rep
                Title: Scientific Reports
                Publisher: Nature Publishing Group UK (London )
                ISSN (Electronic): 2045-2322
                Publication date (Electronic): 24 July 2017
                Publication date PMC-release: 24 July 2017
                Publication date Collection: 2017
                Volume: 7
                Electronic Location Identifier: 6244
                Affiliations
                [1 ]Orthopaedic Center of People’s Liberation Army, the Affiliated Southeast Hospital of Xiamen University, Zhangzhou, China
                [2 ]ISNI 0000 0004 1936 973X, GRID grid.5252.0, Experimental Surgery and Regenerative Medicine, Department of Surgery, , Ludwig-Maximilians-University (LMU), ; Munich, Germany
                Article
                Publisher ID: 6602
                DOI: 10.1038/s41598-017-06602-4
                PMC ID: 5524756
                PubMed ID: 28740251
                SO-VID: 5c7fab4a-b382-4740-aa87-20c57c33ae5b
                Copyright © © The Author(s) 2017
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 8 November 2016
                Date accepted : 14 June 2017
                Categories
                Subject: Article
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                issue-copyright-statement © The Author(s) 2017

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