From the Guidelines
Surgery is only advised for patients with an ATFL complete tear and a cuboid fracture who require quick recovery, such as professional athletes, or whose complaints are not resolved by conservative treatment. When considering treatment for an ATFL complete tear with a cuboid fracture, it is essential to prioritize morbidity, mortality, and quality of life as the outcome. According to the most recent evidence, the treatment approach should be based on the patient's specific needs and preferences 1.
Key Considerations
- The initial management of the injury should focus on pain reduction and swelling management, which may involve the use of NSAIDs 1.
- Immobilization should not be used in the treatment of a LAS, and instead, functional support is preferred, especially the use of a brace 1.
- Exercise therapy should be started as soon as possible to recover joint functionality, and for recurrent ankle sprains, exercise should be included in regular training activities as much as possible 1.
- The cuboid fracture management depends on displacement; non-displaced fractures typically heal with 4-6 weeks of non-weight bearing in a cast or boot, while displaced fractures may require surgical fixation.
Treatment Approach
- A comprehensive treatment plan should be developed, taking into account the patient's overall health, activity level, and goals.
- The treatment plan should include a combination of pain management, functional support, and exercise therapy, with the goal of restoring ankle stability and foot mechanics.
- The patient should be closely monitored and the treatment plan adjusted as needed to ensure optimal recovery and minimize the risk of complications.
Rehabilitation
- Rehabilitation should progress gradually from non-weight bearing to partial and then full weight bearing as healing occurs.
- The rehabilitation program should focus on range of motion, proprioception, and strengthening exercises to restore ankle stability and foot mechanics.
- The patient should be educated on proper rehabilitation techniques and encouraged to adhere to the treatment plan to ensure optimal recovery.
From the Research
ATFL Complete Tear with Cuboid Fracture
- The provided studies do not directly address the topic of an ATFL complete tear with a cuboid fracture 2, 3, 4, 5, 6.
- However, the studies discuss the diagnosis and treatment of acute injuries to the anterior talofibular ligament (ATFL) and other lateral ankle structures 2, 3, 4.
- One study found that augmented ATFL repair with non-augmented CFL repair was the best option for controlling anterior translation at time zero 3.
- Another study introduced a surgical technique for arthroscopic ATFL repair using the Internal Brace and lasso-loop technique for chronic ankle lateral instability, which achieved satisfactory clinical outcomes 4.
- The studies also discuss the biomechanical properties of the ATFL and its fascicles in stabilizing the ankle, as well as the incidence of ATFL injuries in children and adolescents 5, 6.
- There is no direct evidence in the provided studies to assist in answering the question about the treatment of an ATFL complete tear with a cuboid fracture.