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  1. Teow G
    Med J Malaysia, 1979 Mar;33(3):277-8.
    PMID: 118323
    Matched MeSH terms: Ankle Injuries*
  2. Khalid YM, Gouwanda D, Parasuraman S
    Proc Inst Mech Eng H, 2015 Jun;229(6):452-63.
    PMID: 25979442 DOI: 10.1177/0954411915585597
    Ankle rehabilitation robots are developed to enhance ankle strength, flexibility and proprioception after injury and to promote motor learning and ankle plasticity in patients with drop foot. This article reviews the design elements that have been incorporated into the existing robots, for example, backdrivability, safety measures and type of actuation. It also discusses numerous challenges faced by engineers in designing this robot, including robot stability and its dynamic characteristics, universal evaluation criteria to assess end-user comfort, safety and training performance and the scientific basis on the optimal rehabilitation strategies to improve ankle condition. This article can serve as a reference to design robot with better stability and dynamic characteristics and good safety measures against internal and external events. It can also serve as a guideline for the engineers to report their designs and findings.
    Matched MeSH terms: Ankle Injuries/physiopathology; Ankle Injuries/rehabilitation*
  3. Teoh YX, Alwan JK, Shah DS, Teh YW, Goh SL
    Clin Biomech (Bristol, Avon), 2024 Mar;113:106188.
    PMID: 38350282 DOI: 10.1016/j.clinbiomech.2024.106188
    BACKGROUND: Despite the existence of evidence-based rehabilitation strategies that address biomechanical deficits, the persistence of recurrent ankle problems in 70% of patients with acute ankle sprains highlights the unresolved nature of this issue. Artificial intelligence (AI) emerges as a promising tool to identify definitive predictors for ankle sprains. This paper aims to summarize the use of AI in investigating the ankle biomechanics of healthy and subjects with ankle sprains.

    METHODS: Articles published between 2010 and 2023 were searched from five electronic databases. 59 papers were included for analysis with regards to: i). types of motion tested (functional vs. purposeful ankle movement); ii) types of biomechanical parameters measured (kinetic vs kinematic); iii) types of sensor systems used (lab-based vs field-based); and, iv) AI techniques used.

    FINDINGS: Most studies (83.1%) examined biomechanics during functional motion. Single kinematic parameter, specifically ankle range of motion, could obtain accuracy up to 100% in identifying injury status. Wearable sensor exhibited high reliability for use in both laboratory and on-field/clinical settings. AI algorithms primarily utilized electromyography and joint angle information as input data. Support vector machine was the most used supervised learning algorithm (18.64%), while artificial neural network demonstrated the highest accuracy in eight studies.

    INTERPRETATIONS: The potential for remote patient monitoring is evident with the adoption of field-based devices. Nevertheless, AI-based sensors are underutilized in detecting ankle motions at risk of sprain. We identify three key challenges: sensor designs, the controllability of AI models, and the integration of AI-sensor models, providing valuable insights for future research.

    Matched MeSH terms: Ankle Injuries*
  4. Syarifah Aisyah, S.A.H., Elvy Suhana, M.R., Srijit, D., Norzana, A.G.
    Medicine & Health, 2016;11(2):117-130.
    MyJurnal
    Ankle injuries are commonly seen in various sports. The main aim of the present
    review was to highlight the normal anatomy of the ankle, mechanism of injuries
    related to sports, congenital abnormalities or anatomical variations related to
    ankle injury and discuss its effective management. A review of literature was done
    to determine the ankle injuries which occur as a result of various sports related
    activities. We documented all sports which involved injury to the ankle joint. The
    anatomy of various structures in the sole of foot and their involvement in injuries
    were discussed at length. The anatomical knowledge of ankle injury may be
    beneficial for future diagnosis and treatment purpose.
    Matched MeSH terms: Ankle Injuries
  5. Shahrulazua A, Ariff Sukimin MS, Tengku Muzaffar TM, Yusof MI
    Singapore Med J, 2010 Mar;51(3):235-41.
    PMID: 20428746
    The purpose of this study was to evaluate the early functional outcome following the use of a bioabsorbable suture anchor to simplify the repair of injured lateral ankle structures as a variation of an established technique known as the Brostrom-Gould procedure.
    Matched MeSH terms: Ankle Injuries/rehabilitation; Ankle Injuries/surgery*
  6. Wong, H.Y., Vivek, A.S., To, BC Se
    Malays Orthop J, 2008;2(1):28-32.
    MyJurnal
    Int roduction: Treatment of calcaneal fracture is still controversial and indication for surgery is not well
    established. We are reporting the mid term outcome of calcanel fractures treated conservatively. Material and Methods: Patients admitted with calcaneal fractures from 1st November 2002 till 31st December 2004 and were treated conservatively were included in this study. The fractures were grouped according to Essex-Lopresti classification and their outcomes were assessed with the Maryland foot score. We also looked at time to weight bearing and returning to occupational activity. Results: Forty-four patients were included for evaluation. Patients with extraarticular calcaneal fractures had significantly higher rating scores compared to those with intraarticular fractures (98.2 and 88.8 respectively, with a p value = 0.0001). Generally, both group of patients had a good clinical outcome. 18 of the 44 patients (41%) started partial weight bearing before or at 6 weeks and 31 patients (72%) were able to start full weight bearing by 12 weeks. 31 patients (72%) were back to work 12 weeks after the injury. Conclusion: Conservative management for calcaneal fractures is an acceptable mode of treatment with satisfactory.
    Matched MeSH terms: Ankle Injuries
  7. Vikram M, Sundaraganesh K, Justine M, Kurup M, Leonard JH
    Clin Ter, 2012;163(5):383-6.
    PMID: 23099965
    The main objective of the study was to investigate postural control impairment in athletes with history of ankle injury by using Balance Error Scoring System (BESS) and to compare with the controls.
    Matched MeSH terms: Ankle Injuries/physiopathology*
  8. Aimanan K, Chea CH, Lim KY, Damodaran A
    BMJ Case Rep, 2019 May 24;12(5).
    PMID: 31129637 DOI: 10.1136/bcr-2018-228255
    Pseudoaneurysm of the ankle involving the posterior tibial artery is a rare presentation with only four paediatric cases previously reported in English literature. We report a new case following blunt trauma with the clinical presentation and management strategy. A 6-year-old boy presented with a pulsatile swelling at the medial aspect of ankle following a history of blunt trauma 3 weeks ago. Imaging confirmed pseudoaneurysm involving the distal posterior tibial artery. Excision of the pseudoaneurysm was performed without any complication.
    Matched MeSH terms: Ankle Injuries/complications
  9. George J, Jaafar Z, Hairi IR, Hussein KH
    J Sports Med Phys Fitness, 2020 May;60(5):749-757.
    PMID: 32141272 DOI: 10.23736/S0022-4707.20.10050-1
    BACKGROUND: The objectives of this study were to find correlation between the clinical and ultrasound grading in anterior talofibular ligament and calcaneofibular ligament tear, and to determine the sensitivity and specificity of the two stability tests among the athletes. Subsequently, we would like to propose a new grading criterion for an ultrasound examination.

    METHODS: Two blinded assessors examined thirty-five patients with a history of recent lateral ankle sprain. The first assessor performed physical examination on the injured ankle by using the anterior drawer test and talar tilt test, and the second assessor performed dynamic and static ultrasound assessment for anterior talofibular ligament and calcaneofibular ligament. The clinical laxity grading and sonographic extent of ligamentous injury was graded into a three-point scale.

    RESULTS: There was a moderate positive correlation between clinical test and ultrasound grading of anterior talofibular ligament and calcaneofibular ligament with Spearman's correlation coefficient values of 0.58 and 0.66 respectively. Clinical grading of anterior drawer test had 59.1% sensitivity (95% CI: 0.36-0.79) while ultrasound grading had 100.0% specificity (95% CI: 0.75-1.00), with positive likelihood ratio of 0.77 and negative likelihood ratio of 0.44 in detecting a complete (grade 3) anterior talofibular ligament tear (P<0.05). Meanwhile, the clinical grading of talar tilt test had 54.5% sensitivity (95% CI: 0.23-0.83) and ultrasound grading had 100.0% specificity (95% CI: 0.85-1.00), with positive likelihood ratio of 1.0 and negative likelihood ratio of 0.45 in detecting a complete grade 3 calcaneofibular ligament tear (P<0.05).

    CONCLUSIONS: The dynamic ultrasound is recommended to determine the actual degree of disruption of the ligament especially when clinical grading under-grades the degree of tear. Grade 2 tears can vary from 10% tear to 90% tear causing the clinical correlation to become less strong. We recommend a new classification for ultrasound grading of grade 2 tears, which could result in a stronger correlation between clinical and ultrasound grading.

    Matched MeSH terms: Ankle Injuries/diagnosis*
  10. Cheng WL, Jaafar Z
    J Sports Med Phys Fitness, 2020 Jun;60(6):895-902.
    PMID: 32487984 DOI: 10.23736/S0022-4707.20.10619-4
    BACKGROUND: Lateral ankle sprain is the most common injury in basketball, and many of these sprains resulted in residual functional deficits. This study aimed to compare ankle strength and range of motion, and postural balance between competitive basketball players with and without lateral ankle sprain.

    METHODS: This was a cross-sectional study involving 42 male competitive basketball players. Subjects were divided into the injured and uninjured groups based on self-reported questionnaires. Ankle range of motion (ROM) was measured using a goniometer, ankle isokinetic strength testing performed using Biodex System 4 PRO, and single-leg stability tests performed using Biodex Balance System SD.

    RESULTS: Between the injured and uninjured ankles, there was a decrease in plantarflexion ROM (44.89±6.85 vs. 50.75±9.31, P<0.05) and an increase in eversion ROM (14.50±5.63 vs. 11.74±4.53, P<0.05). There was a reduction in inversion and plantarflexion strength at 30°/s peak torque and 120 °/s peak torque (P<0.05). However, no significant difference observed in the postural stability indexes between the two groups.

    CONCLUSIONS: This study proves that there are residual ROM and strength deficits after an ankle sprain, however, these deficits do not affect their balance ability.

    Matched MeSH terms: Ankle Injuries/physiopathology*
  11. Sobhani-Eraghi A, Panahi M, Shirani A, Pazoki-Toroudi H
    Malays Orthop J, 2020 Nov;14(3):155-160.
    PMID: 33403077 DOI: 10.5704/MOJ.2011.024
    Introduction: Doxycycline is a commonly used antibiotic that is also a potent inhibitor of matrix metalloproteinase (MMPs). The use of doxycycline in repairing tendon lesions has been previously investigated and conflicting findings have been reported on its effectiveness. In this study, we sought to evaluate the effects of exposure to doxycycline on Achilles tendon repair.

    Materials and Methods: Twenty healthy rats of the same breed and gender were randomly assigned to two groups of sham, and Doxycycline group therapy. The rats underwent a surgical intervention in which a 2mm incision was performed on the lateral sides of the right Achilles tendons. The treatment group received oral gavage administrations of 50mg/kg/day of doxycycline for 30 days. After this duration, tissue samples were taken from the site of the injuries, which were then histologically evaluated for alignment of the collagen fibres, inflammation reaction, cellular density, and fibroblastic activity.

    Results: The histological assessment of the tissue samples, revealed significant changes in the repaired tissues of the treatment group in comparison to the sham group; namely more irregularity in the alignment of the collagen fibres, increased cellular density, and increased fibroblastic activity. However, only the alignment of the collagen fibres reached the statistical significance.

    Conclusion: The results of this study indicate that exposure to doxycycline may result in the improvement of repair of the Achilles tendon injuries, especially collagen filament integrity.

    Matched MeSH terms: Ankle Injuries
  12. Mohd Salim NS, Umar MA, Shaharudin S
    J Taibah Univ Med Sci, 2018 Dec;13(6):576-581.
    PMID: 31435381 DOI: 10.1016/j.jtumed.2018.10.007
    Objectives: The isokinetic evaluation of the ankle joint is important in determining the effectiveness of the rehabilitation programme for the management of ankle sprains. This study aimed to determine the effects of physiotherapy programme on isokinetic variables in individuals with grade I ankle sprains.

    Methods: Seven patients with acute grade 1 ankle sprain (15 days of ankle sprain) were recruited. They were provided with 7 days of protection, optimal loading, ice, compression, and elevation (POLICE) treatment, and the standard physiotherapy programme consisted of towel stretching and balancing exercises on one leg. Pain scale score was recorded daily during the physiotherapy programme. The isokinetic ankle strengths of the patient's injured and uninjured legs were compared before and after the physiotherapy programme. Isokinetic tests were conducted in painless range of motion for the injured leg.

    Results: Pain was significantly reduced after the patients underwent the standard physiotherapy programme. No significant differences were observed in terms of the ankle peak torque, time to peak torque, and ankle plantar flexion-to-dorsiflexion ratio of the injured and uninjured legs. The injured leg showed significant improvement in terms of ankle eversion-to-inversion ratio (E:I) after 7 days of performing the standard physiotherapy programme.

    Conclusion: Performing the standard physiotherapy programme for 1 week reduces pain and improves the ankle E:I in patients with grade 1 ankle sprain.

    Matched MeSH terms: Ankle Injuries
  13. Quan Fu Gan, Pooi Pooi Leong, Soon Keng Cheong, Chai Nien Foo
    MyJurnal
    Ankle sprain is one of the most common injuries associated with physical activities. Complications including pain and ankle instability are associated with decreased physical activity, reduced sport performance, and increased risk of recurrent ankle injury leading to detrimental effect on activities of daily living. Current management of ankle sprain can be conservative or surgical for serious cases. However, long healing period is required for conservative management in addition to its side effects and the risk of post-operative complications for surgical management. Due to the current challenges and setbacks faced by existing intervention, this paper aims to generate ideas in incorporat- ing regenerative medicine as an intervention for ankle sprain. This review will provide a brief review on the existing management for ankle sprain along with some history, application and the potential of regenerative medicine in speeding up the healing process of ankle sprains.
    Matched MeSH terms: Ankle Injuries
  14. Nawfar SA, Chan KL, Idham HM, Izani IM, Nahulan T
    Malays Orthop J, 2015 Nov;9(3):8-16.
    PMID: 28611903 MyJurnal DOI: 10.5704/MOJ.1511.001
    INTRODUCTION: Calcaneal fractures are caused by high energy trauma and mostly are intra-articular fractures. Nondisplaced intra-articular calcaneal fracture (IACF) can be treated non-operatively. However, displaced intra-articular need to be reduced and fixed anatomically to facilitate early ankle rehabilitation and minimize functional impairment. This study was done to find out the outcome of the IACF patients who underwent operative treatment.

    METHODS: 62 patients with IACF were selected in this study and had been followed up from June 2009 to May 2013. They were placed into two groups; the operative treated and non-operative treated groups. Bilateral ankle lateral view plain radiographs were taken for comparison of the Bohler and Gissane angles. Both groups of patients were assessed by the Maryland Foot Score (MFS) and the SF-36v2 general health survey questionnaire. The ability of the patients to perform activity of daily living (ADL) and /or return to work (RTW) was assessed as well.

    RESULTS: The operative treatment group of displaced IACF patients achieved no significant better scores in the mean MFS and SF-36v2 mean scores as compared to non operated cases. There was no difference in RTW between the 2 groups, but earlier ADL was recorded in the operated group. However, this study had found 5 associated factors which causes major effect to the patients' outcome to treatment.

    CONCLUSIONS: The patient's compliance with post-operative rehabilitation regimen were found to be significantly related with the outcomes.
    Matched MeSH terms: Ankle Injuries
  15. Bulut G, Colak I, Mik G, Kilic Z, Tasdemir Z
    Malays Orthop J, 2018 Jul;12(2):47-51.
    PMID: 30112129 DOI: 10.5704/MOJ.1807.009
    An 18-year old male patient, with a history of paragliding accident, sustaining a coronal shear fracture of the body of the talus, an anterior process fracture of the calcaneus extending to the calcaneocuboid joint and a nondisplaced navicular body fracture at the right foot and a displaced fracture of the navicular body accompanied with posteromedial process fracture of the talus at the left side was referred to our emergency clinic. For the right foot, the coronal plane fracture of the talar body was anatomically reduced and fixed with screws. For the left foot, screw fixation was performed through the lateral aspect to fix the large posteromedial fragment. Small bone fragments were removed from the left navicular fracture, and the main fragments were also fixed with screw. The talo-navicular joint was stabilised with a Kirschner wire. At 36 months follow-up, bilateral foot and ankle functions were satisfactory, Maryland scores of the right and left foot were 85 (good) and 90 (excellent), respectively, and the patient regained his full activity level by the 5th month postoperatively. With reference to the number and types of fractures in this one patient, we present a standard protocol for treatment of isolated talus, navicular and calcaneal fractures presenting together in a single foot injury.
    Matched MeSH terms: Ankle Injuries
  16. Nadarajah A, Abrahan L, Lau FL, Hwang LJ, Fakir-Bolte C
    Singapore Med J, 2006 Jun;47(6):534-42.
    PMID: 16752024
    INTRODUCTION: Cyclooxygenase (COX)-2 selective inhibitors are attractive candidates for treatment of ankle sprain because of their efficacy as anti-inflammatory and analgesic agents and their overall safety, including lack of effect on platelet aggregation. The objective of this study was to assess the efficacy and tolerability of celecoxib compared with diclofenac slow release (SR) in the treatment of acute ankle sprain in an Asian population.
    METHODS: In this seven-day, multicentre, double-blind, randomised, parallel-group trial, 370 patients with first- or second-degree ankle sprain occurring at or less than 48 hours prior to the first dose of study medication were randomised to receive celecoxib 200 mg bid (189 patients) after a 400 mg loading dose or diclofenac SR 75 mg bid (181 patients). Patients were required to demonstrate moderate to severe ankle pain on weight bearing (45 mm or greater on a 100 mm visual analogue scale [VAS]) at baseline. The primary efficacy end point was the patient's assessment of ankle pain (VAS on full weight bearing) on day 4.
    RESULTS: Celecoxib was as effective as diclofenac SR in improving the signs and symptoms of ankle sprain. At day 4, mean VAS scores for celecoxib and diclofenac SR had decreased to 28 mm and 30 mm, respectively. Treatment differences were not statistically significant. Incidence of upper gastrointestinal adverse events was low in both treatment groups (0.5 percent versus 2.2 percent for celecoxib and diclofenac SR, respectively).
    CONCLUSION: Celecoxib, a COX-2 selective inhibitor, is as effective as diclofenac SR in treating ankle sprains. With its platelet-sparing properties, celecoxib may offer an advantage over diclofenac SR in managing musculoskeletal injuries.
    Matched MeSH terms: Ankle Injuries/drug therapy*; Ankle Injuries/physiopathology
  17. Balaji G, Bhukya S, Nema S, Rajeswari M, Vellaipandi V
    Malays Orthop J, 2021 Mar;15(1):85-92.
    PMID: 33880153 DOI: 10.5704/MOJ.2103.013
    Introduction: Unstable ankle injuries require anatomical reduction and stabilisation for optimal outcome. In spite of adequate care, a few patients have poor outcome. In this study, we assessed the risk factors that predict the clinical outcomes in surgically treated unstable ankle fractures.

    Material and methods: This prospective cohort study was conducted on 68 patients who underwent surgical management for an unstable ankle injury. Demographic details, fracture type and associated medical comorbidities were recorded. Pre-operative radiographic assessment was done for all patients. At the end of one year follow-up, clinical (American Orthopaedic foot and ankle society-AOFAS and Olerud-Molander ankle - OMAS) scores and radiological parameters were assessed and analysed.

    Results: Fracture dislocation (0.008), diabetes mellitus (0.017), level of alchohol consumption (0.008) and pre-operative talocrural angle (TCA) > 100° (0.03) were significant predictors of poor outcomes as per AOFAS. Fracture dislocation (0.029), diabetes mellitus (0.004), pre-operative TCA > 100° (0.009), female gender (0.001), age more than 60 years (0.002) and open injuries (0.034) had significantly poor outcome as per OMAS. Other parameters (smoking, hypertension, classification, syndesmotic injury, medial clear space and tibiofibular overlap) did not affect the outcome significantly.

    Conclusion: Our study showed that poor outcome predictors in unstable ankle fractures are age >60 years, female gender, diabetes mellitus, alcohol consumption, fracture dislocation, open fractures and pre-op TCA >100°.

    Matched MeSH terms: Ankle Injuries
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