Ankle

Question 1

Lateral Collateral Ligaments

Answer 1

Anterior talofibular ligament (ATFL)
Calcaneofibular ligament (CFL)
Posterior talofibular ligament (PTFL)

Question 2

Deltoid Ligaments

Answer 2

Posterior tibiotalar portion
Tibiocalcaneal portion
Anterior tibiotalar portion
Tibionavicular portion

Question 3

Common sprains to Lateral Collateral Ligaments

Answer 3

1st = ATFL is the most common sprain in inversion
2nd = ATFL + CFL
3rd = all of them

Question 4

Common sprains to Deltoid Ligaments

Answer 4

eversion sprains (is thicker and stronger)

Question 5

functional tests for ankle

Answer 5

Walk on toes (plantar flexion)
Walk on heels (dorsiflexion)
walk on lateral and medial borders of feet
Hops on injured ankle
Start and stop running
-active, passive, resistive mvmnts

Question 6

inversion sprains

Answer 6

Most common and result in injury to the lateral ligaments
- anterior talofibular ligament injured w inversion, plantar flexion, internal rotation
- force can be great enough for avulsion fracture w lateral malleolus

Question 7

Ottawa Ankle Rules

Answer 7

○ Pain in malleolar or midfoot area
○ Tenderness over inferior or posterior pole of either malleoli
○ Inability to bear weight (4 steps taken independently, even if limping) at time of injury and/or evaluation
○ Tenderness along base of 5th metatarsal or navicular bone

Question 8

grade 1 ligament sprain

Answer 8

E:
- occur when inversion, plantarflex, adduct
- stretching of anterior talofibular ligament
- 0-30% torn
S/S:
- Mild pain and disability; weight bearing is minimally impaired; point tenderness over ligaments and no laxity
M:
- Tape
-return to activity in 7-10 days

Question 9

Managment for Different Degrees of Sprains

Answer 9

RICE for 1-2 days

Question 10

Grade 2 Ligament Sprain

Answer 10

E:
-moderate inversion causing lots of disability over many days
- 30-70% torn
S/S:
hear / feel pop or snap moderate pain w/ difficulty bearing weight; tenderness and edema
M:
x-ray
crutches 5-10 days
rehab to prevent re-injury

Question 11

Grade 3 Ligament Sprain

Answer 11

E:
- uncommon but extremely disabling
- significant force cause inversion and spontaneous subluxation and reduction
- damage to anterior/posterior talofibular and calcaneal ligaments
-70-100% torn
S/S:
unable to bear weight, severe pain, swelling, hemarthrosis, discoloration
- Positive talar tilt and anterior drawer

Question 12

Eversion Sprains

Answer 12

5-10% of all ankle sprains
E:
- bony protection and ligaments decrease chance of injury
- eversion forces damage deltoid ligament and fibula fracture
S/S:
Pain may be severe; unable to bear weight
M:
Same inversion
-Grade 2 or higher will present with considerable instability and may cause weakness in medial longitudinal arch resulting in excessive pronation or fallen arch

Question 13

Syndesmotic Sprains

Answer 13

• High ankle sprain
• Often injured with medial/lateral ankle ligaments
  E:
• Ankle dorsiflexion or external rotation
  S/S:
  looks like an ankle sprain but higher up
  M:
• Difficult to treat and may requires months of treatment
• same as other sprains but rehabilitation might be longer