Physicians have been advised to err on the side of caution when diagnosing common foot and ankle injuries, or it may result in arthritis, chronic pain and disability, new research suggests.
A new study by orthopedic surgeons published in the February edition of the Journal of the American Osteopathic Association, outlined subtleties that complicate identification and treatment of “snowboarder’s fractures” (lateral talar process fractures) as well as os trigonum injuries, Lisfranc injuries, turf toe, navicular stress fractures and syndesmotic injuries.
These types of injuries account for more than 3 million emergency room visits in the United States each year are related to common foot and ankle injuries. The authors encourage clinicians to obtain additional imaging or a second opinion from an orthopedic surgeon to confirm the initial diagnosis.
“These types of trauma are a clinically significant source of morbidity and long-term disability among patients, not just those who are elite athletes. In many cases, the clinical symptoms are vague and tough to detect with standard imaging,” said lead author Jessica Reissig, DO, of the Department of Orthopedics at Plainview Hospital in New York in a press release. “As an osteopathic physician, I view treatment of foot and ankle injuries as acute and preventative care because a mismanaged injury leads to so many future problems for patients.”
The authors noted that the potential for severe pain and disability, as well as a high correlation to future arthritis are associated with untreated snowboarder’s fractures. Additionally, improper treatment of other foot and ankle traumas can result in compensation injuries and other issues including tendinitis and recurrent ankle sprains.
While in many cases, these injuries can be resolved with a combination of medication, immobilization, ice and rest, some require surgical intervention. Elite athletes may also opt for surgery in order to resume their sport sooner, said co-author Adam Bitterman, DO, of the Hofstra Northwell School of Medicine.
“Once the diagnosis is confirmed, in many cases patients can be offered a range of treatment options from conservative to surgical. Choosing the best treatment for the individual can prevent the injury from decreasing the patient’s future quality of life,” Dr. Bitterman explained.