Dr. Ebraheim’s educational animated video describes the ligaments of the Ankle.
An ankle sprain is usually low ankle sprain, but occasionally high ankle sprain.
Other conditions associated:
•Osteochondral lesion
•Peroneal tendon subluxation
•Lateral process fracture of the talus
•Anterior process fracture of the calcaneus
•High syndesmotic injury
Tests for injury of these ligaments:
•Anterior drawer test
•Squeeze test
•External rotation stress test
•Talar tilt test (inversion test).
If the patient can’t bear weight on the ankle, the patient should get an xray.
Injury to the deltoid ligament occurs on the medial side of the ankle joint and usually associated with fracture.
Injury to the lateral side ligament is referred to as ankle sprain.
The anterior tibiofibular ligament is the west on the lateral side. Anterior drawer test: is done to test the competency of the anterior tibiofibular ligament. The test is done in 20 degrees of plantar flexion and compares it to the other side. A shift of an absolute value of 9 mm on the lateral xray or 5mm compared to the other side is positive.
The calcaneofibular ligament is usually injured after the anterior talofibular ligament. talar tilt test: less than 5 degrees of tilt is usually normal.
A high ankle sprain may require surgery.
Always track the fibula proximally to avoid missing a Maisonneuve fracture.
Squeeze test is used to diagnose high ankle sprain. By squeezing the tibia and fibula at the midcalf this causes pain at the syndesmosis if high ankle sprain is present. External rotation stress test: place the ankle in a neutral position, then apply external rotation stress and get a mortise view radiograph. The positive result if the tibiofibular clear space is more than 5 mm. there is also a positive result if the medial clear space is more than 4 mm.

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