Lateral Ligament Sprain

Question 1

What is a lateral ligament sprain?

Answer 1

Inversion ankle sprain.

Question 2

Aetology of lateral ligament sprain.

Answer 2

Forced plantar flexion/inversion movement.

Going over on ankle

Question 3

What is grade 1 sprain?

Answer 3

Mild strain
Pain and tenderness over Anteriir talor-fibular ligament.
No swelling
No laxity

Question 4

What is a grade 2 sprain?

Answer 4

Moderate 
Marked tenderness
Maybe swelling 
Some laxity- distinct end point 
Stable

Question 5

What is a grade 3 sprain?

Answer 5

Severe - often other ligament involved ATFL, CFL, PTFL 
Complete tear 
Feeling instability 
Pain is variable 
Gross laxity -no distinct end point
Instability on testing

Question 6

Clinical features of lateral ligament sprain.

Answer 6

Severe pain
Excessive swelling 
Difficulty moving or putting weight on ankle
Ankle stiffness
Deformity
Rom reduced

Question 7

Epidemiology of lateral ligament sprain.

Answer 7

1. 85% of all ankle sprains sporting activities

2. 7/10,000

Question 8

What are the intrinsic and extrinsic factors of lateral ligament sprain?

Answer 8

Intrinsic- previous sprain, incomplete rehab, loss of proprioception, weak muscles, dominant limb, excessive plantar flexion, postural sway.

Extrinsic- uneven surface, shoe type, competition duration, intensity of activity.

Question 9

What is the pathophysiology of lateral ligament sprain?

Answer 9

Damage to the ligament as a result if forced plantar flexion/inversion movement.
A ligament is a fibrous, elastic bands of tissues that connect and stabilise bones.

Question 10

What is the healing process for lateral ligament sprain?

Answer 10

Hemostatsis- bleeding. Platelets in contact eith collagen results in activation. Prothrombin is converted to thrombin and fibrrinogen is converted to fibrin. Form fibrin cross-linking to strengthen the platelet clumps into a stable clot coagulation. 4-6hrs.

Inflammation- focuses on destroying bacteria/removing debris. White blood cells (neutrophils) enter the wound and destroy bacteria. An inflammatory response releases inflammatory cytokines e.g serotonin , bradykinin, histamine. Onve neutophils leaves macrophages enter clear debris. Secrete growth factors/proteins to facilitate repair. 5 cardinal signs of inflammation.

Proliferation- distinct stages with stage.
1. Filling wound - shiny, deel, red granulation tissue fills the wound bed with connective tissueand new blood vessels are formed
2. Contraction of wound margins- wound margins pull towards the centre if wound.
3. Covering the wound (epithelialisation)-> epithelial cells arise from the wound bed it margins and migrate across the wound until completely covered
4 - 24 days

Remodeling- new tissue slowly gains strength/flexibility. Collagen fibres reorganise the tissue remodels/matures. Increase in tensile strength (max strength limited to 80% of preinjured strength) 21 days - 2 years