Acute Ankle Injury

Question 1

List common types of Ankle injuries
(3 mainly)

Answer 1

• ATFL.
• CFL.
• PTFL.

Question 2

List less common types of Ankle injuries
(6 types)

Answer 2

• Osteochondral lesion of the talus.
• Medial ligament injury.
• AIRFL injuries.
• Fractures.
• Dislocations.
• Tendon rapture.

Question 3

What questions are NB of history of injury?

Answer 3

• Mechanism of injury.
• Onset of pain and other symptoms.
• Weight bearing after injury.
• Degree of instability.
• initial Mx.
• Previous history of injuries.

Question 4

What are the aims of ankle assessment?

Answer 4

• Assess degree of instability.
• Detect functional deficits.
• Detect any associated injuries.

Question 5

What does assessment entail?

Answer 5

• Observation.
• Active movement.
• Passive movements.
• Resisted movement.
• Functional tests.
• Palpation.
• Special tests.

Question 6

Ottawa ankle rule A

Answer 6

Bone tenderness at lateral malleolus (posterior tip).

Question 7

Ottawa ankle rule B

Answer 7

Bone tenderness at medial malleolus (posterior edge).

Question 8

Ottawa ankle rule C

Answer 8

Bone tenderness at base of the fifth metatarsal.

Question 9

Ottawa ankle rule D

Answer 9

Bone tenderness at the navicular bone.

Question 10

How is a lateral ankle injury managed?
(Time + 6 principles)

Answer 10

• Reduce pain and swelling.
• Restore FROM.
• Muscle conditioning.
• Proprioception.
• Functional exercises.
• Return to sports.

It takes 8 -10 weeks for more intensive neuromuscular training to achieve an effect.

Question 11

Gr III ankle injury consideration and time frame

Answer 11

Grade III ankle injury warrants :
- initial conservative management (at least 6 -12 weeks) irrespective of the level of the athlete.

Question 12

Difference between a medial and lateral ligament injury of the ankle?

Answer 12

• lateral ligament injury is more common with the usual mechanism being inversion and plantarflexion.

Question 13

The difficult ankle: List atypical sprains that may occur

Answer 13

• Chronic ligament Instability.
• Medial ligament sprain.
• Syndesmosis sprain.
• Subtalar joint sprain.

Question 14

The difficult ankle: List Tendon injuries that may occur

Answer 14

• Chronic peroneal tendon weakness.
• Peroneal tendon subluxation/rapture.
• Tibialis posterior tendon subluxation/rapture.

Question 15

What special tests would you use to test injury of the lateral ligaments of the foot
(Name and Indication)

Answer 15

• Inadequate rehabilitation
• Chronic synovitis
• Sinus tarsi syndrome
• Complex regional pain syndrome type 1.

Question 16

What special tests would you use to test injury of the medial ligaments of the foot
(Name and Indication)

Answer 16

Reverse kleiger’s test.
- talar tilt test: with varying dorsi or plantar flexion to test for various areas.

Question 17

What special tests would you use to test injury of the ATFL of the foot
(Name and Indication)

Answer 17

• Anterior drawers test

Question 18

What special tests would you use to test injury of the PTFL of the foot

Answer 18

• Posterior drawers test.