Ankle sprains, which are almost the most frequently seen in orthopedic emergencies, account for approximately 25% of skeletal muscle system injuries, the vast majority of which are lateral ligament injuries. Without systematic treatment, repeated ankle sprains can occur and chronic ankle instability can develop, which is one of the most common sports injuries. The main manifestations are ankle instability (e.g., fearful walking on uneven surfaces, etc.) and/or ankle pain and soreness. How to handle the correct management of ankle sprain? The first stage, the principle of emergency treatment for ankle sprain (within 24-48 hours) – RICE principle: rest for the first week to protect the ankle joint and reduce swelling; Rest (rest): stop walking and let the injured part rest quietly to reduce further damage; Ice (ice): let the temperature of the injured part decrease to reduce inflammation and muscle spasm, relieve pain and inhibit swelling. Each time 10-20 minutes, more than 3 times a day, be careful not to apply ice directly to the affected area, can be wrapped in a wet towel ice to avoid frostbite. Ice should only be applied within 48 hours of the injury. Compression: Wrap the injured ankle joint with an elastic bandage and apply appropriate pressure to reduce swelling. Be careful not to apply excessive pressure, as this may increase the swelling and ischemia of the limb far from the wrap. Elevation: Elevate the limb above the heart to increase venous and lymphatic return, reduce swelling, and promote recovery. The available evidence recommends only NSAIDs to control pain and inflammatory response. It is worth mentioning that there is no clear evidence to support all topical medications and manipulative rubbing for revision. Phase 2, weeks 2-3, gradually restores joint mobility, strength and flexibility; Phase 3, over the next few weeks to months, gradually begins to return to sports, starting with sports that do not require twisting of the ankle joint and eventually returning to sports. Studies in the international literature have shown that 80-85% of patients can recover well with various conservative treatments. However, more than 15% of patients will become chronically unstable, with residual intractable ankle pain and joint instability. The internationally accepted rehabilitation program is mostly 12 weeks as a treatment course (3 months), which means that 12 weeks of conservative treatment should be effective, and conversely, if there is no effect, further examination and treatment may be required; recovery of tissue damage after 6 months is less likely. For example, if the nerve injury does not recover after 6 months, nerve release or functional reconstruction is needed; fracture does not heal after 6 months, which is called bone non-union, etc. This is especially true for the recovery of ligaments, cartilage and other soft tissues with poor healing properties. Therefore, the international community has long recognized the poor efficacy of conservative treatment after 6 months as a criterion for surgical treatment; therefore, we recommend that for patients with first-time ankle sprains, after excluding fractures, a comprehensive evaluation and formal conservative treatment should be performed first, and for patients with pain/unsteadiness/discomfort symptoms after up to 6 months of conservative treatment, further treatment, including surgery, should be performed early and accordingly, depending on the symptoms. Surgical modalities ligament repair, ligament reconstruction. With the development of medical technology, minimally invasive arthroscopic treatment of ankle ligament injuries has become possible, bringing the possibility of faster recovery for patients with ankle instability. If conservative treatment is ineffective and patients who need surgical treatment simply refuse surgery, it may aggravate the condition and delay the timing of treatment. The longer the time after the ankle ligament injury, the more serious the cartilage injury within the ankle joint; the longer the ankle sprain, the more times, the more serious the ligament resorption, so that the opportunity of ligament suture is lost during surgery, and only reconstructive surgery can be performed; the longer the ankle sprain, the more times, the more serious the other concurrent injuries, including cartilage, free body, lower tibiofibular separation, synovitis, bone superfluous and other injuries, so that the surgery is affected The outcome of the surgery. Although surgery is not a panacea, more often than not, timely surgical treatment can lead to better restoration of motor function! Consultation with a specialist and a thorough evaluation of ankle function is important to understand the condition and to further develop a treatment plan. Ankle instability usually presents with a positive anterior drawer test as well as a positive talar tilt test, which can also be demonstrated on orthogonal inversion stress films of the ankle joint, in addition to MRI which helps in the determination of ligament tears. Performing the examination at a later stage is more helpful in determining the stability of the ankle joint. In addition, isometric muscle strength test and balance sensory test help to assess the muscle strength of the muscles around the ankle joint is beneficial to the development of rehabilitation program and assessment of efficacy. Recommendations for patients with ankle sprains: early rice principle, timely consultation with a specialist, standardized diagnosis and treatment, and further examination and treatment for patients with ankle sprains with poor results after more than 6 months of conservative treatment to avoid more serious consequences!