Overview
Ankle fracture subluxation involves displacement of the talus within the ankle mortise, often associated with ligamentous injury. This can lead to chronic ankle instability and functional deficits 23.Diagnosis
Ultrasonography (US) demonstrates high sensitivity for diagnosing chronic anterior talofibular ligament (ATFL) injuries 1.
Magnetic resonance imaging (MRI) also shows good sensitivity for ATFL injuries, particularly in acute settings 1.
Stress radiography can be used for chronic ATFL injuries 1.
MR arthrography has 100% sensitivity for chronic ATFL injuries 1.Management
Balance training is more effective than regular exercise for improving functionality, ankle instability, and dynamic balance in individuals with chronic ankle instability 2.
Balance training is more effective than strength training for improving functionality, but not for instability or dynamic balance 2.
Dynamic control techniques, such as external skeletal fixation, can be used for anterior ankle subluxation 3.Key Recommendations
Ultrasonography is a valuable imaging technique with high sensitivity for diagnosing chronic lateral ankle ligament injuries 1. (Evidence: Strong)
Balance training significantly improves functionality, instability, and dynamic balance outcomes in people with chronic ankle instability 2. (Evidence: Strong)
Dynamic control of anterior ankle subluxation can be achieved with techniques like external skeletal fixation 3. (Evidence: Expert opinion)References
1 Cao M, Liu S, Zhang X, Ren M, Xiao Z, Chen J et al.. Imaging diagnosis for anterior talofibular ligament injury: a systemic review with meta-analysis. Acta radiologica (Stockholm, Sweden : 1987) 2023. link
2 Mollà-Casanova S, Inglés M, Serra-Añó P. Effects of balance training on functionality, ankle instability, and dynamic balance outcomes in people with chronic ankle instability: Systematic review and meta-analysis. Clinical rehabilitation 2021. link
3 Hansen ST. External skeletal fixation: special techniques: dynamic control of anterior ankle subluxation. Foot and ankle clinics 2004. link