Introduction Ankle sprains are one of the most common injuries presenting to emergency departments, representing 3% to 5% of all visits in the UK, and 10% of all injury-related visits in the USA. Ankle injuries have significant physical and economic consequences for the affected individuals.

Objectives To describe the epidemiology of ankle sprains and fractures among the general population; and to determine the direct and indirect costs related to the diagnosis and treatment of ankle injuries.

Methods A comprehensive literature review of Ovid MEDLINE, EMBASE, Cochrane DSR, ACP Journal Club, AMED, Ovid Healthstar, and CINAHL was conducted for English-language studies on ankle sprains and fractures published from 1980 to 2010.

Results The search identified 2394 studies of which 47 were selected for analysis. A majority of the studies were published in the last decade. The incidence of ankle sprains was 2 to 7 per 1000 person-years, while the incidence of ankle fractures was 1 per 1000 person-years. The costs of emergency ankle sprain management ranged from 126.13 to 2356.21 per patient (2009 CAD), depending on sprain severity. The management costs were higher for ankle fractures: 1692.82 to 15 802.26 (2009 CAD) per patient. The economic evaluations were conducted from the societal or healthcare system perspective.

Conclusions Information on the epidemiology of ankle sprains and fractures may help plan for health policy and the provision of health services. Moreover, the cost data may inform future studies undertaking economic evaluations of the diagnosis and treatment of ankle injuries.