Exam II Lecture 9 Ankle Sprains Dr Dayton Flashcards
What is the lateral collateral ligament anatomy?
Calcaneofibular ligament
Anterior talofibular ligament
Posterior talofibular ligament
What is the angle between the ATFL and the Talofibular ligament?
105 degrees
What are the deltoid ligaments?
Anterior tibiotalar ligament Most deep
Posterior tibiotalar ligament Assists FHL
Tibiocalcaneal ligament Strongest
tibionavicular ligament weakest blending with spring ligament.
What is the anterior distal tibial angle?
80 degrees +/- 2 degrees
What is the lateral distal tibial angle?
89 degrees +/- 3 degrees
Which bone of the ankle joint takes most of the pressure?
the talus due to its increased surface area.
Force is also transmitted to the tibia and fibula.
What is a Class I ankle sprain?
Ligamentous stretching without macroscopic tearing
What is a Class II ankle sprain?
This is a partial macroscopic tearing
What is a Class III sprain
Complete ligamentous rupture
What is the most common motion that causes an ankle sprain?
Inversion/plantarflexion
What heel position can increase the risk of ankle sprains?
Varus heels.
More likely to invert the foot.
What functional instability can cause ankle sprains?
Proprioceptive defects play a large role in intability in comparison to muscle strength.
What does the anterior Draw test check?
ATFL
What does the inversion stress test check? (Talar Tilt test)
When is it positive?
The calcaneal fibular ligament
It is positive if greater than 10 degrees in comparison to the other side.
What does the external rotation and squeez test check?
These are checking the ankle syndesmosis for a high ankle sprain.
You externally rotate the leg while maintaining the foot in dorsiflexion. If pain is created this shows there may be syndesmotic damage.
Squeeze test just recreates pain when squeezing the syndesmosis shut.
What are the Ottawa rules?
These relate palpated pain in certain areas to the risk of fractures in ankle sprains.
What is the most important think for rehabilitation of ankle sprains?
Position sense of the ankle.
What is a functional chronic ankle stability caused by?
Proprioceptive injuries!
What is an anatomic chronic ankle unstability injury caused by?
Misalignment of the bone or ligament laxity (less of an issue compared to bone displacement).
Brostrom-Gould Procedure?
Lateral collateral ligament repaired with extensor retinaculum
What biomechanical issues can lead to repeated inversion events?
Tibial varum
Calcaneal varus
Ankle varus
what is the normal Tib fib clearspace?
< 6 mm
What is the normal Tib fib overlap measurement?
10 mm but not the best measurement as its easily changed with rotation.
