Anterior Talofibular Ligament

advertisement
Ankle Injuries

Ankle Sprains

Single most common injury in athletics caused
by sudden inversion or eversion moments
Tibia
Fibula
Lateral Malleolus
Medial Malleolus
Bones
of
Foot & Ankle
Medial Aspect
Medial Malleolus
Head of Talus
Foot & Ankle Bones
Tarsal
sinus
Calcaneous
Cuboid
Lateral View
3rd - 5th
Metatarsals
Talus
Lateral Ligaments
Anterior Tibiofibular Ligament

Palpation



External Rotation Test
Locate area where tibia and
fibula meet
Spring Test
Anterior Talofibular Ligament

Palpation


Superior to sinus tarsi
Anterior Drawer Test



Anterior translation of talus under tibia
May cause a clunking at end point
Indicates laxity
Posterior Talofibular Ligament


Posterior Drawer Test
Stabilize Tibia


Apply a posterior stress to the foot and ankle
Posterior translation indicates ligament laxity
Talar Tilt Test (Varus Stress)

Assessment

Calcaneofibular ligament

Apply a varus stress to calcaneous

Grade 1-3+

Feel for cluck
Deltoid Ligaments
Valgus Stress Test
Inversion Sprains

Injury to the lateral ligaments


Anterior talofibular ligament

Inversion

Plantar flexion

Internal rotation
Calcaneofibular ligament

Inversion
Inversion Sprain

Symptoms

Pain




Active motion
Resistive motion
Loss of function
Signs



Tenderness
Swelling
Ecchymosis
1º Inversion Sprain

Symptoms

Pain: mild





Active motion
Resistive motion
Loss of function
Weight bearing minimally impaired
Signs





Point Tenderness
Swelling
Ecchymosis
No laxity
Management







RICE
Weight bearing to tolerance
Tape or brace
Modalities as needed
Strengthening
Return to activity when functional
Average return 7-10 days
2º Inversion Sprain


Etiology


Moderate inversion force
Pathology

Partial tearing of ligaments



Anterior Talofibular
Calcaneofibular
Signs and Symptoms



Pop or snap heard or felt
Moderate pain
Moderate disability



Management

RICE up to 72 hours

X-ray if unable to weight bear

Crutches 5-10 days

Progress to weight bearing

Protective immobilization

Tape or brace

Modalities as needed

Early ROM exercises

Strength & proprioception
exercises

Return to activity when
functional

Average return 7-10 days
Difficulty bearing weight
Tenderness
Edema
3º Inversion Sprain

Etiology

Signs and Symptoms



Relatively uncommon

Significant inversion force


Subluxation and relocation



Pathology

Anterior talofibular ligament

Calcaneofibular ligament





Anterior tibiofibular ligament
Severe pain
Edema
Hemarthrosis (blood in joint)
Ecchymosis
Inability to bear weight
Positive Tests
Anterior drawer
Talar Tilt
Management


RICE
Refer to MD
Eversion Sprain

Etiology




Indirect
Direct force
Eversion of ankle
Inversion of ankle



Signs

Crush injury

Symptoms


Pain




Tenderness

Active motion
Resistive motion
Loss of function
Weight bearing

Collapse of arch

Special Tests



Deltoid ligaments
Swelling
Ecchymosis
Valgus stress
External rotation test
Management


Arch and ankle taping
Orthotics
Ankle
Dislocation

Assess neurovascular status
Download