Guideline for diagnosis and treatment of acute inversion trauma of the ankle in athletes

This multidisciplinary guideline has been developed as an aid to diagnosis and treatment of patients, especially athletes, with an acute inversion trauma of the ankle. Diagnosis of an acute inversion trauma is by means of a combination of location of the swelling, palpation and executing an anterior drawer test. X-rays are only indicated if weight-bearing is not possible and palpation of specific areas according to the 'Ottawa ankle rules' causes pain. Physical diagnostic examination 4-5 days post-trauma is a reliable method for discriminating between ankle sprain and lateral ligament rupture.- Rest, application of ice, compression and elevation (RICE) during the first days post-trauma is recommended. Analgesic therapy, with paracetamol as medication of choice, should be restricted to 2-7 days post-trauma. Conservative treatment is preferential to surgical treatment. A semi-rigid brace protection should become a standard treatment procedure. Exercise therapy results in a faster recovery and a faster resumption of work and sporting activities. Exercises to improve proprioception, coordination and muscle strength are indicated.