In the last two years, I have encountered many patients with ankle sprains during outpatient visits and visits to acquaintances, which has given me a new perspective on this disease. When I was a child and growing up in junior high and high school, we often encountered sprains and strains, but we never sought formal medical attention or special treatment, and they all “healed naturally. Similarly, in the case of ankle sprains, in my previous medical practice, I was not particularly worried about the patient having bad consequences after taking a film without a fracture, but after many cases, I believe that ankle sprains without fractures are a disease that is even more difficult to heal than fractures. Case 1: After a male friend sprained his left ankle playing basketball, he was photographed in our hospital without any fracture, I suggested him to rest for at least half a month and put it in a cast at the same time, but he had to travel a lot for work, and he thought it would be fine if there was no fracture, so he politely refused my request. He replied that he still had vague pain from time to time and was uncomfortable, and that he rarely played basketball, and that he had to be gentle, or else the pain would flare up. Case 2: A friend from out of town saw his ankle sprain in a local hospital, and it was not fixed in a cast, and he felt fine, but the pain recurred and has not healed after more than half a year. After contacting me, she came to Changsha for consultation at the weekend. Although the injury had passed for more than half a year, I still suggested her to fix the cast for one month and take absolute bed rest, because she was a civil servant, it was more troublesome to grant leave. Later, I was informed during the follow-up visit that she was much better, she still had occasional aches and pains, but the degree was acceptable, and the duration was shorter, and the number of episodes was not too many, so she was much better than before. Case 3: In July this year, a new nurse in our ICU department had an ankle sprain for more than 5 years (she was in her early 20s). At that time, he was not treated formally and had been suffering from pain and discomfort from time to time, so when he came to our department, he was similar to the previous patient and I suggested that he should be fixed in a cast for one month and that it was necessary to perform MRI to see if there was any damage to the ligaments and ankle surface. However, because it is not easy for new staff to take leave, the patient has not yet undergone further treatment such as plaster fixation and MRI, and the pain continues …… Ankle sprains are a frequent affliction in daily life, especially among adolescents, who are very likely to sprain their ankles during sports activities. Pain, swelling, and subcutaneous petechiae occur after ankle sprain, and the pain worsens when the ankle is moved. Examination may reveal local pressure points in the ankle joint. The pain is aggravated by inversion of the foot. Severe cases can lead to partial damage or complete rupture of the ligaments. It can also lead to subluxation or total dislocation of the ankle joint or the lower tibiofibular joint. If the acute ligament injury is poorly repaired and the ligaments are lax, it can easily lead to recurrent injury, resulting in chronic instability of the ankle joint or frequent sprains. A postdoctoral fellow in Changsha Public Security System did not pay attention to the frequent ankle sprains (he thought he was a highly knowledgeable scholar and took care of them by himself after looking up Baidu and other information), which later led to ankle fractures and hospitalization in our department for surgery. To sum up: ankle sprain is an invisible killer, which may stick to you when you ignore it and make you suffer for years and years. So we, whether as patients or doctors, must face it squarely when we come across this condition. The first thing you need to do is to apply a cold compress immediately after the acute injury to reduce local bleeding and swelling by allowing local vasoconstriction. 48 hours later, local physiotherapy can be used to promote tissue healing. 2. X-rays are performed immediately after the injury, and if there is a fracture, then surgical repositioning or manual repositioning and fixation is chosen according to the situation. If there is no fracture, the ankle sprain of the ‘no fracture’ type in this article needs to be fixed in a cast without weight bearing for one month. A small number of people also need MRI to see if the ligament is completely torn or if there is a bony injury that is not easily detectable on X-rays. Patients with partial ligament tears can basically be repaired by fixation in a cast. If the patient has repeated sprains at a later stage, it is necessary to repair the ankle stability with an autologous tendon graft to prevent ankle dislocation and osteoarthritis due to degeneration of the articular cartilage.