Epidemiology of Ankle Sprain in the Military: A Systematic Review of Literature

Abstract

Category: Ankle; Sports Introduction/Purpose: Ankle sprains occur frequently within the general population, however, the extent to which this injury impacts the military population remains unknown. The purpose of this study was to systematically review the literature describing ankle sprains in the military population. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles were retrieved from PubMed, Embase, and Cochrane Library using the search terms 'military,' 'epidemiology,' 'incidence,' 'prevalence,' 'ankle sprain,' and 'ankle instability.' Inclusion criteria consisted of active military duty status, English language, and levels of evidence I-IV. Results: Nineteen articles were included, representing 1,671,763 study participants from six countries and four branches of the military. Among the ten studies that reported ankle sprain incidence in terms of overall injury incidence, seven studies reported ankle sprain as the most common injury, with an incidence ranging from 2.20% to nearly one third of all injuries in the paratrooper population. Ankle sprain was also reported as the most common injury among lower extremity injuries in two studies, with incidences of 35% and 38.7%, respectively. Ankle sprain incidence rate per 1,000 person-years was reported in four studies, with values ranging from 15.3 to 58.4. Incidence rate was also reported for males and females separately in three of these studies, ranging from 33.89 to 52.7 for males, and 41.17 to 96.4 for females. The number of days lost to ankle sprain ranged from one to eight days per servicemember. Conclusion: Ankle sprains are among the most prevalent injuries within the military population, with a reported incidence that is higher for females than males. This injury results in time away from active duty, which impacts overall readiness within the military system.