• Francisco Guerra-Pinto, João Caetano, Rita Alçada, António Brito Camacho, Jácome Pacheco, Diogo Lacerda, Teresa Alves-da-Silva, Nuno Côrte-Real, and José Guimarães Consciência.
• Serviço de Ortopedia. Hospital de Sant'Ana. Parede; Serviço de Ortopedia. Hospital da Cruz Vermelha. Lisboa; NOVA Medical School. Lisboa. Portugal.
• Acta Medica Port. 2022 Jul 1; 35 (7-8): 566-577.

IntroductionThe 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 MethodsWe 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.ResultsAmong 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).ConclusionThis 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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