Ankle Sprain

Last updated 20.05.13

 

Index

 

Definition

-  Ankle injury resulting in sprain of 1+ ligaments from to overstretching

 

Features

-  Common injury

-  Most common sports injury

-  Increased frequency in sports or uneven surfaces

-  Inversion (sole inwards) injury most common (85%)

-  Anterior talofibular ligament (ATFL) most commonly injured

-  Calcaneofibular ligament (CFL) also effected if severe

 

Cause

-  Fall, sudden twist or blow causing rapid or extreme malposition of ankle joint

 

Associated S/S

-  Pain

-  Stiff joint

-  Ankle examination

-  Swelling

-  Erythema, warmth

-  Bruising

-  Antalgic gait, limp

 

DDx

-  Dislocation +/- fracture

 

Grades

-  I: pain, no laxity = stretch of ATFL

-  II: pain, increased laxity = tear of ATFL & stretch of CFL

-  III: pain + unstable ankle joint = tear of ATFL & CFL

-  High Ankle Spain (Syndesmotic Complex): ATFL + PTFL + distal interosseous membrane between tibia & fibula

 

 

Ix

-  Talar tilt test

-  Drawer test: complete tear

-  Squeeze test

-  Squeeze distal tib & fib together

-  Pain = high ankle sprain

-  ROM

-  Neurovascular exam

-  +/- Ultrasound

 

Mx

-  72hrs RICE

-  Physiotherapy

-  Dynamic splinting +/- CAM boot

-  Ankle taping

-  Analgesia: Paracetamol +/- Ibuprofen

-  Sx if grade III in high level athletes or chronic instability