Ankle Ligament Sprain (Lateral and Medial)
Ankle sprains are common injuries that occur from overstretching or tearing of the ligaments that support the ankle. The ankle is composed of the talus, tibia and fibula bones forming the joint, and the ligaments, which are responsible for holding these bones in their proper place. Ligaments and other soft tissues function to prevent abnormal movement such as twisting, turning and rolling of the foot beyond the normal range. Ankle ligament sprains result in pain, swelling, bruising and stiffness of the ankle region. Mobility, range-of-motion and weight-bearing are adversely affected. The severity of the ankle sprain depends on the condition of the torn ligament.
Low ankle sprains are common injuries in young athletes. Hence, it is imperative that low ankle sprains are diagnosed and treated quickly and effectively. We reviewed the: (1) anatomy; (2) imaging; (3) physical exam findings; and (4) treatment modalities regarding these injuries. Plain radiographs are standard of care and routine MRI is not recommended for suspected sprains. However, physical exam findings often may guide management decisions. The majority of patients diagnosed with low ankle sprains are treated with a one- to two-week immobilization period with physical therapy focused on peroneal proprioception and strength. If a prolonged non-operative course fails, or there is gross instability upon physical exam (grade III sprain), surgical reconstruction may be considered and may lead to excellent outcomes. When low ankle sprains do occur, the great majority may be treated non-operatively. In the event that conservative modalities fail, surgical reconstruction may be considered with an open modified Brostrom reconstruction as the current standard of care.
