- An ankle sprain refers to tearing of the ligaments of the ankle.
- The most common ankle sprain occurs on the lateral ankle. High ankle sprain affects the tibio-fibular syndesmosis.
- Grade 1 – “twisted ankle” with mild pain and swelling. No loss of function.
- Grade 2 – partial ligament tear with significant pain, swelling, bruising and loss of function.
- Grade 3 – complete ligament tear unable to weightbear. Severe pain, swelling and bruising.
- Pain and swelling of the ankle.
- Tenderness over the outer front aspect of the ankle.
- Difficulty walking (4 step rule).
- Bruising sometimes present.
Tests and Imaging
- Physical examination and history. Malleolar squeeze test for high ankle sprain.
- Grading of sprain.
- X-rays to exclude fracture if unable to walk 4 steps.
- MRI if complex injury is suspected.
- Crutches and ankle brace to limit inversion/eversion. Night splints may be helpful.
- Podiatry for bracing, stabilisation, night splint, rehabilitation.
- Orthopaedic foot surgeon for patients who have recurrent ankle sprains due to ankle instability, andmay be candidates for ankle ligament stabilization.