Abstract:
PURPOSE : The purpose of this study is to provide a detailed description of
the anatomy and radiology of the medial sleeve and present an approach in
its management among elite athletes.
METHODS : Five cases of elite athletes who underwent treatment for a medial
sleeve injury of which the diagnosis was confirmed through physical examination
and additional magnetic resonance imaging scan are described
in this study.
RESULTS : Two patients presented with isolated medial sleeve injuries, while
the other three patients suffered from concomitant ankle injuries. Nonoperative
treatment consisted of relative rest, soft cast immobilization and
mobilization in a walking boot or kinesiotape which was successful in four of
the cases with regard to the medial sleeve. One patient underwent surgery
due to syndesmotic instability. Another patient presented with combined
medial and lateral ankle instability which was treated surgically with an open
medial and lateral ligament repair. All patients were able to return to their
pre‐injury sports and at the time of the last follow‐up were still playing in
their pre‐injury level of competition.
CONCLUSION : Medial sleeve injuries of the ankle in elite athletes should be
considered in the differential diagnosis for athletes presenting with medial
ankle pain. Inherent knowledge regarding anatomy is essential when
guiding the management of these injuries which can be treated successfully
with a non‐operative approach consisting of relative rest, immobilization,
kinesiotape and physical therapy. In case of persistent medial instability or rotational instability, surgical repair is a viable treatment option. Both modalities
allow athletes to return to the pre‐injury level of competition. However,
early diagnosis is crucial to minimize the delay of appropriate treatment and
avoid potential residual symptoms.
