J Korean Foot Ankle Soc.  2022 Mar;26(1):22-29. 10.14193/jkfas.2022.26.1.22.

Current Trends in the Treatment of Ankle Ligament Injuries: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey

  • 1Department of Orthopedic Surgery, Chungbuk National University Hospital, Cheongju, Korea
  • 2Department of Orthopedic Surgery, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
  • 3Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, Korea
  • 4Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, Korea
  • 5Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea


Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries.
Materials and Methods
A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies.
Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain.
This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.


Ankle; Acute sprain; Chronic instability; Korean Foot and Ankle Society; Survey


  • Figure. 1 Degree of significance of the patient’s symptoms in decision making for surgical treatment and method.

  • Figure. 2 Degree of significance of the radiological factors in decision making for surgical treatment and method.

  • Figure. 3 Degree of significance of the patient-specific factors in decision making for surgical treatment and method. *Factor with tendercy.

  • Figure. 4 Frequency to treat concomitant pathologies during surgical treatment for chronic ankle instability.

  • Figure. 5 Degree of significance of the prognostic factors related to surgical treatment for chronic ankle instability.

  • Figure. 6 Main reason of unsatisfactory outcomes after surgical treatment for chronic ankle instability.


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