Ankle Ligament Sprain

An ankle ligament sprain is the most frequent musculoskeletal injury in athletes and is very common in the general population with it being responsible for 7-10% of all emergency department admissions.

 

Ligaments are fibrous tissues that connect bone to bone. At the ankle there are 3 ligaments on the lateral aspect, the anterior talofibula ligament (ATFL), the calcaneofibula ligament (CFL) and the posterior talofibula ligament (PTFL). These ligaments are the most frequently injured with ankle sprains. On the medial aspect on the ankle there is a large triangular ligament that is made up of 4 separate groups of ligaments that form the deltoid ligament.

 

There is also a group of ligaments above the ankle called the Syndesmosis complex that are made up of the anterior inferior tibifibula ligament (AITFL), the interosseous membrane and the posterior inferior tibiofibula ligament (PITFL).

 

Injuries to these ligaments are graded from Grade 1 to 3.

 

• Grade 1 sprains involves minimal structural damage to the ligaments. These injuries will generally resolve from between 5 days to 2 weeks.

 

• Grade 2 sprains will involve structural damage to the ligaments but without a full thickness tear or rupture. These injuries can lead to ongoing ankle instability and will require a rehabilitation program to restore joint stability and range of movement. It can take 4 to 8 weeks to restore full function.

 

• Grade 3 sprains will involve a complete full thickness tear or rupture of a ligament. This injury will lead to ankle instability and a full 12 week rehabilitation program would be recommended before returning to running or jumping activities. An orthopaedic assessment may also be necessary to discuss possible surgical repair.

 

Surgical management of a grade 3 ankle sprain would consist of ankle stabilization procedure however these can be avoided in up to 90% of cases if a comprehensive rehabilitation program is implemented.