Case 1
Case: An athlete lands awkwardly from a jump, presenting with lateral swelling, a positive (+) Anterior Drawer test, a positive (+) inversion Talar Tilt test, but negative tests for eversion and syndesmosis.
What are the three main ankle ligaments on the lateral side?
What are the Anterior Talofibular (ATF), Calcaneofibular (CF), and Posterior Talofibular (PTF) ligaments?
Case: An athlete steps off a curb and presents with medial swelling, negative Anterior Drawer, negative inversion Talar Tilt, but a positive (+) eversion Talar Tilt and negative Kleiger's test.
Which ankle ligament is present on the inside of the ankle?
Deltoid Ligament
Case: An athlete's leg gets caught during a tackle. They present with lateral and anterior lower leg swelling, an antalgic gait, negative drawer and tilt tests, but positive (+) Kleiger's and positive (+) squeeze tests.
What does a squeeze test measure for the ankle?
The ankle squeeze test (fibular compression test) measures the integrity of the distal syndesmosis and in the lower leg to help identify a high ankle sprain
Where is the Subtalar Joint located and what motions does it perform?
It is located between the Talus and Calcaneus and is responsible for inversion and eversion.
Case: An athlete lands awkwardly from a jump, presenting with lateral swelling, a negative (-) Anterior Drawer test, a positive (+) inversion Talar Tilt test, but negative tests for eversion and syndesmosis.
How can the positive inversion Talar Tilt test define which ligaments may be injured?
The positive standard/inversion Talar Tilt test assesses the Calcaneofibular (CF) ligament.
Case: An athlete steps off a curb and presents with medial swelling, negative Anterior Drawer, negative inversion Talar Tilt, but a positive (+) eversion Talar Tilt and negative Kleiger's test.
What does a Kleiger's Test measure?
Kleiger's test evaluates for a high ankle sprain (distal tibiofibular syndesmosis injury) or a deltoid ligament injury on the medial side of the ankle
Case: An athlete's leg gets caught during a tackle. They present with lateral and anterior lower leg swelling, an antalgic gait, negative drawer and tilt tests, but positive (+) Kleiger's and positive (+) squeeze tests.
What is your primary assessment?
High Ankle Sprain
Case: An athlete lands awkwardly from a jump, presenting with lateral swelling, a negative (-) Anterior Drawer test, a positive (+) inversion Talar Tilt test, but negative tests for eversion and syndesmosis.
What is your primary assessment?
Lateral Ankle Sprain, specific to the CF ligament
Case: An athlete steps off a curb and presents with medial swelling, negative Anterior Drawer, negative inversion Talar Tilt, but a positive (+) eversion Talar Tilt and negative Kleiger's test.
What is your primary assessment?
Medial Ankle Sprain
Case: An athlete's leg gets caught during a tackle. They present with lateral and anterior lower leg swelling, an antalgic gait, negative drawer and tilt tests, but positive (+) Kleiger's and positive (+) squeeze tests.
What is another name for a high ankle sprain?
Syndesmotic Ankle Sprain
Case: An athlete lands awkwardly from a jump, presenting with lateral swelling, a negative (-) Anterior Drawer test, a positive (+) inversion Talar Tilt test, but negative tests for eversion and syndesmosis.
Which ligament does the Anterior Drawer test specifically test for?
(ATFL) anterior talofibular ligament
Case: An athlete steps off a curb and presents with medial swelling, negative Anterior Drawer, negative inversion Talar Tilt, but a positive (+) eversion Talar Tilt and negative Kleiger's test.
If the athlete cannot bear weight, swelling expands from the localized area, and the ankle feels very loose, what does that say about the grade of sprain?
This could likely be a grade 3 injury with the inability to bear any weight and non-localized swelling.
Case: An athlete's leg gets caught during a tackle. They present with lateral and anterior lower leg swelling, an antalgic gait, negative drawer and tilt tests, but positive (+) Kleiger's and positive (+) squeeze tests.
What is the function and role of the syndesmosis in the ankle?
The distal tibiofibular syndesmosis connects the tibia and the fibula just above the ankle joint, forming a stable arch (mortise) that grips the top of the foot bone.
Case: An athlete lands awkwardly from a jump, presenting with lateral swelling, a negative (-) Anterior Drawer test, a positive (+) inversion Talar Tilt test, but negative tests for eversion and syndesmosis.
Why are lateral ankle sprains more common?
The outer ankle bone (the lateral malleolus) sits lower than the inner ankle bone, which mechanically permits the foot to roll inward more easily
Case: An athlete steps off a curb and presents with medial swelling, negative Anterior Drawer, negative inversion Talar Tilt, but a positive (+) eversion Talar Tilt and negative Kleiger's test.
*Extra: There is a "Deltoid" muscle somewhere on the body. Where is that located?
The outside of the shoulder.
Case: An athlete's leg gets caught during a tackle. They present with lateral and anterior lower leg swelling, an antalgic gait, negative drawer and tilt tests, but positive (+) Kleiger's and positive (+) squeeze tests.
What are the MOI's for a High Ankle Sprain?
Ankle dorsiflexion combined with external rotation (DF w/ ER)