Consecutive Ankle Sprain Classification and Injury Systematization (CASCaIS), A New Lateral Ankle Sprain Classification Based on the Pivot Test: A Prospective Cohort Study

Authors

  • Francisco Guerra-Pinto Serviço de Ortopedia. Hospital de Sant’Ana. Parede. Serviço de Ortopedia. Hospital da Cruz Vermelha. Lisboa. NOVA Medical School. Lisboa. https://orcid.org/0000-0002-6186-0229
  • João Caetano Serviço de Ortopedia. Hospital Dr. José de Almeida. Cascais.
  • Rita Alçada Serviço de Ortopedia. Hospital Dr. José de Almeida. Cascais.
  • António Brito Camacho Serviço de Ortopedia. Hospital Dr. José de Almeida. Cascais.
  • Jácome Pacheco Serviço de Ortopedia. Hospital de Sant’Ana. Parede.
  • Diogo Lacerda Serviço de Ortopedia. Hospital de Sant’Ana. Parede.
  • Teresa Alves-da-Silva Serviço de Ortopedia. Hospital Dr. José de Almeida. Cascais. https://orcid.org/0000-0003-1007-6570
  • Nuno Côrte-Real Serviço de Ortopedia. Hospital Dr. José de Almeida. Cascais.
  • José Guimarães Consciência NOVA Medical School. Lisboa. Serviço de Ortopedia. Hospital de São Francisco Xavier. Centro Hospitalar Lisboa Ocidental. Lisboa.

DOI:

https://doi.org/10.20344/amp.13804

Keywords:

Ankle Injuries, Ankle Lateral Ligament, Prognosis

Abstract

Introduction: The biggest challenge in the treatment of acute ankle sprain is the uncertainty of the prognosis. The traditional classifications have several interpretations and little correlation with prognosis. In this study we propose a new classification for acute ankle sprain only based on clinical criteria.
Material and Methods: We prospectively evaluated all patients with an ankle sprain, aged between 18 and 45 years, admitted to a hospital during a 24 month period. The minimum follow-up period was 12 months. The sprains were classified, in the first few days (CASCaIS-Initial), according to autonomous gait capacity, inspection and palpation. After a few weeks (CASCaIS-Deferred), it was complemented with the mechanical evaluation of ligaments through the ankle pivot test.
Results: Among the 49 patients who completed the follow-up, none of those who had a pivot-negative test progressed to chronic ankle instability (CAI). Nine of the 33 patients (27%) with a positive pivot progressed to CAI (p = 0.022). The evaluation of CASCaIS-Deferred demonstrated an association with CAI (p = 0.018).
Conclusion: This classification proved to be a simple, inexpensive, and reliable tool that clinicians can use to determine the prognosis of the sprain.

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Author Biographies

Francisco Guerra-Pinto, Serviço de Ortopedia. Hospital de Sant’Ana. Parede. Serviço de Ortopedia. Hospital da Cruz Vermelha. Lisboa. NOVA Medical School. Lisboa.

Ortopedista

João Caetano, Serviço de Ortopedia. Hospital Dr. José de Almeida. Cascais.

Interno de Ortopedia

Rita Alçada, Serviço de Ortopedia. Hospital Dr. José de Almeida. Cascais.

Interna de Ortopedia

António Brito Camacho, Serviço de Ortopedia. Hospital Dr. José de Almeida. Cascais.

PhD

Assistente de Ortopedia

Jácome Pacheco, Serviço de Ortopedia. Hospital de Sant’Ana. Parede.

Interno de Ortopedia

Diogo Lacerda, Serviço de Ortopedia. Hospital de Sant’Ana. Parede.

Interno de Ortopedia

Teresa Alves-da-Silva, Serviço de Ortopedia. Hospital Dr. José de Almeida. Cascais.

Assistente de Ortopedia

Nuno Côrte-Real, Serviço de Ortopedia. Hospital Dr. José de Almeida. Cascais.

Assistente Graduado de Ortopedia

Director Clínico

José Guimarães Consciência, NOVA Medical School. Lisboa. Serviço de Ortopedia. Hospital de São Francisco Xavier. Centro Hospitalar Lisboa Ocidental. Lisboa.

PhD, Agg

Director de Serviço do Serviço de Ortopedia do Centro Hospitalar Lisboa Ocidental – Hospital de São Francisco Xavier

Published

2022-07-01

How to Cite

1.
Guerra-Pinto F, Caetano J, Alçada R, Brito Camacho A, Pacheco J, Lacerda D, Alves-da-Silva T, Côrte-Real N, Guimarães Consciência J. Consecutive Ankle Sprain Classification and Injury Systematization (CASCaIS), A New Lateral Ankle Sprain Classification Based on the Pivot Test: A Prospective Cohort Study. Acta Med Port [Internet]. 2022 Jul. 1 [cited 2022 Nov. 30];35(7-8):566-77. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13804