Ankle: Ligament Pathology 1

Question 1

Differential dx for lateral ankle pain

Answer 1

• lateral ankle sprain
• distal fibular fx
• peroneal tendon injury
• peroneal/sural nerve irritation

Question 2

Differential dx for lateral foot pain

Answer 2

• jones fx (5th met head)
• cuboid subluxation
• mechanical subtalar dysfunction

Question 3

Most common form of ankle sprain

Answer 3

Lateral

Question 4

Lateral ankle sprains: Results in (laxity)

Answer 4

Talocrural and subtalar joint laxity

Question 5

Lateral ankle sprains: Clinical findings (ROM)

Answer 5

Painful PROM into inversion

Question 6

Lateral ankle sprains: ttp

Answer 6

ATFL
CFL
PTFL

Question 7

Lateral ankle sprains: Stress tests

Answer 7

(+) anterior drawer, talar tilt

Question 8

Grade I: ligament tear

Extent

Answer 8

None

Question 9

Grade II: ligament tear

Extent

Answer 9

Partial

Question 10

Grade III: ligament tear

Extent

Answer 10

Complete

Question 11

Grade I: loss of functional ability

Extent

Answer 11

Minimal

Question 12

Grade II: loss of functional ability

Extent

Answer 12

Some

Question 13

Grade III: loss of functional ability

Extent

Answer 13

Great

Question 14

Grade I: pain

Extent

Answer 14

Minimal

Question 15

Grade II: pain

Extent

Answer 15

Moderate

Question 16

Grade III: pain

Extent

Answer 16

Severe

Question 17

Grade I: swelling

Extent

Answer 17

Minimal

Question 18

Grade II: swelling

Extent

Answer 18

Moderate

Question 19

Grade III: swelling

Extent

Answer 19

Severe

Question 20

Grade I: ecchymosis

Extent

Answer 20

Usually none

Question 21

Grade II: ecchymosis

Extent

Answer 21

Common

Question 22

Grade III: ecchymosis

Extent

Answer 22

Yes

Question 23

Grade I: difficulty bearing weight

Extent

Answer 23

None

Question 24

Grade II: difficulty bearing weight

Extent

Answer 24

Usual

Question 25

Grade III: difficulty bearing weight

Extent

Answer 25

Almost always

Question 26

Grade I lateral ligament injuries:

Initially need to control…

Answer 26

Pain and inflammation

Question 27

Grade I lateral ligament injuries:

Need to restore what ASAP

Answer 27

AROM/PROM

Question 28

Grade I lateral ligament injuries:

To restore AROM/PROM, should do what ASAP

Answer 28

Manipulate ASAP!

Question 29

Grade I lateral ligament injuries:
AROM/PROM restoration

Initiate what early to avoid too much stress to healing ligament

Answer 29

Midrange

Question 30

Grade I lateral ligament injuries:

Early strengthening

Answer 30

OKC strengthening with tubing

Question 31

Grade I lateral ligament injuries:

From OKC, progress to

Answer 31

WB and CKC strengthening

Question 32

Grade I lateral ligament injuries:

May return to play in (timeframe)

Answer 32

1-2 weeks

Question 33

Lateral ligament injuries: Grade II

Initial management

Answer 33

• Similar to grade 1 injuries

- May need crutches initially to walk

Question 34

Lateral ligament injuries: Grade II

May take how long to return to play

Answer 34

2-3 weeks

Question 35

Lateral ligament injuries: Grade II

Functional testing should be (%) of uninvolved side for return to play

Answer 35

90%

Question 36

Lateral ligament injuries: Grade III

Debate between what management options

Answer 36

• conservative treatment with immobilization

- early surgical repair

Question 37

Lateral ligament injuries: Grade III

Initial conservative mgmt

Answer 37

• cryotherapy
• NSAIDs
• compression garments

Imperative

Question 38

Lateral ligament injuries: Grade III

External supports likely useful x (timeframe)

Answer 38

1-2 weeks

Question 39

Lateral ligament injuries: Grade III

Begin with walking boot, progress to hinged ankle brace, to no brace over the course of

Answer 39

6-8 weeks

Question 40

Lateral ligament injuries: Grade III

Protective devices for sports may be recommended up to (timeframe)

Answer 40

1 year