Week 8 - physical exam of the ankle and foot

Question 1

acute ankle injuries

Answer 1

→ Lateral ligament injuries
o MOI – INV suggests lateral ligaments, EVN suggests medial ligaments, compressive forces consider osteochondral injury, sometimes audible snap/crack/tear.
o Onset – able to WB immediately suggests spa

Question 2

ATFL in ankle sprains

Answer 2

Anterior-lateral ligament sprain – ATFL
→ First ligament to tear – torn in 97% of cases.
→ Moi – plantarflexion and inversion.
→ Physically examination – localized pain (antero-lateral).

Question 3

CFL in ankle sprains

Answer 3

CFL
→ Usually in conjunction with ATFL – isolated rupture rare (3% of inversion injuries)
→ Physical examination – localised pain (lateral, below lateral malleolus),

Question 4

PTFL in ankle sprains

Answer 4

PTFL
→ Last ligament to tear
→ Complete tear of ATFL, CFL and PTFL rare and results in dislocation of ankle joint.
→ Isolated rupture of PTFL rare.

Question 5

AITFL

Answer 5

AITFL
→ MOI – hyper-DF force OR.
o ER with axial load.

→ Physical examination
o Swelling above T/C joint
o Pain with WB DF (reduced with compression of malleoli together).
o ER stress test.
o DF compression test
o ROM, strength, and balance.
o Confirmed with imaging.
o Patient will point to lateral dorsal ankle.

Question 6

acute ankle injuries