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Ankle Sprain


Discussion

pathoanatomy:

  • fibular collateral ligament is made up of three separate structures;
  • cervical ligaments:
  • deltoid ligament resists abduction & lateral rotation of foot;
    • sudden and forceful eversion, inverson, or rotation of the foot may tear the ligament stressed, or by acting through the ligament, may avulse the attached malleolus;
    • in the vast majority of cases there will be a tear thru the ligament mid-substance;
    • associated talar compression of opposite malleolus may cause frx;
  • anterior talofibular ligament:
    • w/ inversion force of foot, there is injury to anterolateral capsule, ATFL, & anterior tibiofibular ligament;
    • about 40% of patients will have this injury type;
  • calcaneofibular: as force progresses, this ligament is injured as well;
    • in about 58% of cases, there will be a tear of both the ATFL and the CF ligament;
  • finally in a small number of cases (3%) there will be tears of the above two ligament and the posterior talofibular ligaments;

differential diagnosis: ankle sprains:

Physical Exam

  • be sure to look for concomitant syndesmotic and subtalar instability;
  • note any dysesthesia from the peroneal nerves, and point this out to the patient;

Radiographic Studies for Ankle Sprains

Non Operative Treatment

Operative Management

References