Lateral ligament sprain

• MOI:

  • Inversion injury
  • commonly Anterior talofibular ligament is injured
  • Calcaneofibular ligament and Posterior talofibular ligament can also be injured
• Complications:

  • Tibiofibular Joint damage
  • Osteochondral lesions - medial aspect of talus smashes against tibia
  • Tendon dislocation/tear
  • Avulsion fractures
• Signs & Symptoms:

  • Local pain
  • Swelling/effusion
  • Local/distal bruising
  • +/- Instability
  • +/- +ve Anterior Draw
  • +/- +ve Talar Tilt Test
• To exclude fractures - Ottawa Ankle Rules:

  • lateral side: tenderness on bone on distal 6 cm of lateral malleolus / base of 5th metatarsal
  • medial side: tenderness on bone on distal 6 cm of medial malleolus / navicular
  • tenderness on any of those areas indicate higher risk of fracture, so xray is needed

  
• Treatment - Be aware of healing timescales

  • POLICE/taping/splinting/cryocuff
  • Manual therapy
  • Balance control (including proprioception)
  • Muscle strength/endurance
  • Proximal control
  • Functional rehab