Ankle and foot
Lateral ankle ligament injury
- Mechanism
- Forced inversion with plantar flexion. In that position the anterior talofibular ligament alone is under tension; with more force the calcaneofibular ligament follows, and only with severe force the posterior talofibular ligament.
- Recognition
- Swelling and tenderness in front of and below the lateral malleolus, difficulty bearing weight, and a positive ankle anterior drawer after a few days. Always run the Ottawa ankle rules first.
- Course
- Most ankles are functionally recovered within six weeks, but up to a third keep residual complaints or sprain again. Persisting lateral pain after three months more often points to an osteochondral defect or cuboid subluxation than to the ligaments themselves.
- What the guideline recommends
- Functional treatment with early weight bearing and a brace gives faster recovery than immobilisation. Proprioceptive training lowers the chance of recurrence.
Structures
- Anterior talofibular ligament (ATFL)
- Calcaneofibular ligament (CFL)
- Posterior talofibular ligament (PTFL)
Joints involved
Clinical tests
Sources
- Stiell IG, McKnight RD, Greenberg GH, McDowell I, Nair RC, Wells GA e.a.. Implementation of the Ottawa ankle rules. JAMA 271(11):827-832. 1994
- Magee DJ, Manske RC. Orthopedic Physical Assessment, 7e editie. Elsevier. 2021