Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Inversion ankle sprainLateral ankle sprainATFL sprainATFL tears ++ 845.0 Ankle sprain ++ S93.409A Sprain of unspecified ligament of unspecified ankle, initial encounter ++ 4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with connective tissue dysfunction +++ Description ++ Disruption of anterior lateral ligament of the ankleMay be acute or chronicThe anterior talofibular ligament (ATFL) restricts anterior translation of the talusThe ATFL also restricts inversion and adduction at the subtalar jointMost commonly injured with rapid inversion, adduction, and plantarflexion movements, in either contact or non-contact situationsPain and edema at lateral ankleCan occur with structure progression to the calcaneofibular ligament and then posterior talofibular ligament +++ Essentials of Diagnosis ++ Positive anterior drawer test and talar tilt testUltrasonography, radiography, or MRI may be utilized in select cases.2Ultrasonography or MRI is recommended following an inversion ankle sprain in a patient with chronic ankle instabilityRadiographs utilized within the constraints of Ottawa ankle rulesATFL tears are classified based on the anatomical degree of damage or functional stability found on clinical examAnatomicalGrade 1: partial microscopic tearing of the ligament, minimal to no loss of function, mild swelling and painGrade 2: partial macroscopic tearing of the ligament, with mild-moderate loss of function, moderate swelling/pain/tendernessGrade 3: complete rupture with severe loss of function, severe swelling/pain/tendernessFunctional stabilityStable: no laxity with talar tilt or anterior drawer testing (Grade I)Unstable: laxity with anterior drawer testing (ATFL, Grade II); laxity with both anterior drawer and talar tilt (ATFL and CF, Grade III) +++ General Considerations ++ May occur with concomitant calcaneofibular (CF) sprain, posterior talofibular sprain, synovitis, chondral lesion, or fractureMost commonly sprained ankle ligament +++ Demographics ++ Prevalent in athletes, though does occur in sedentary individualsMost common in basketball, soccer, and football4Males between 15 and 24 years old have higher rates of ankle sprains than female counterparts; females over 30 years old have higher rates than male counterparts.4A previous ankle sprain is the strongest predictor of a subsequent ankle sprain.5 +++ Signs and Symptoms6 ++ Pain in lateral ankle or footGrade 1: minimalGrade 2: moderateGrade 3: severeMay posture in greater pronation to avoid plantarflexed/inversion momentsEdema lateral ankleGrade 1: minimalGrade 2: moderateGrade 3: severePain with palpation of ATFLPossible inability to bear partial or full weightGuarded active/passive inversion range of motion (ROM)May have increased inversion passive ROM (positive Talar tilt test)Decreased active/passive dorsiflexion ROMDecreased peroneal/eversion strengthIn moderate to severe cases, increased talar anterior glide on mortise (positive anterior drawer test) +++ Functional Implications6 ++ Loss of functional ... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth