Document

Association between Ambient Temperature and Ankle Sprain

Description

Background:

Understanding the environmental factors that contribute to anterior Ankle Sprain injuries is crucial for long-term ankle instability leading to ankle arthritis. Prior studies have mainly examined intrinsic factors, leaving a knowledge gap regarding the impact of weather conditions on such injuries.

 

Objective:

This study aims to investigate the association between ambient temperature and the incidence of ankle sprain injuries and evaluate the cold or o

 

Methods:

This was a retrospective cohort study with 191 patients (age (mean (SD)) 34.7 (15.7); female n=792 (47.6%); male n=871 (52.4) who visited an emergency department due to ankle sprain between 2017 and 2022 at a general hospital in Tel Aviv, Israel. Weather data including daily average temperature for the injury date was integrated with individual patient information. The Distributed Lag Non-linear Model (DLNM) with a time-stratified case-crossover model was applied to analyze the relationship between ankle sprain injuries and ambient temperature. We defined 5 percentiles of annual temperature as cold and 95 percentile of annual temperature as hot temperature.

 

Results:

DLNM analysis showed that the risk of ankle sprain was negatively associated with the ambient temperature. The cold temperature was 11.9 Celsius degree, and the hot temperature was 28.7 Celsius degree. Lag analysis showed cold weather cumulatively associated with increased risk of ankle sprain. (Relative risk (RR) [95% CI] 2.81 [1.57­–5.02]) The hot weather tended to associate with decreased risk of ankle sprain. (RR [95%CI] 0.56 [0.29–1.07])

 

Discussion:

Overstretched and weakened anterior talofibular ligament caused by ankle sprain can lead to instability and poor balance, increasing the risk of further sprains consequently leads to cartilage damage and degenerative changes in the ankle joint. Previous studies have shown that various risk factors such as weak ankle and hip-joint muscles, can increase the risk of experiencing an ankle sprain, irregular terrain surfaces, heavy, and sports participation. Colder weather conditions may interact with these risk factors, potentially amplifying the risk of an ankle sprain as compared to warmer climates.

 

Conclusion:

Ambient temperature was negatively associated with the risk of ankle sprain injuries and there was a cumulative association of cold temperature with ankle sprain. To be aware of the increased risk of ankle sprains, one should be aware of prolonged cold and further investigation is needed.

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Authors

T O

Takahsia Ogawa

MD, MPH, PhD

Department of Orthopedic Surgery, Saku General Hospital, Nagano, JAPAN

H S

Haggai Schermann

MD, MPH

Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, ISRAEL

A L

Adi Lichtenstein

MD

Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, ISRAEL

T Y

Toshitaka Yoshii

MD, PhD

Department of Orthopedics, Tokyo Medical and Dental University, Tokyo, JAPAN

ESSKA Continuous Professional Education Partners