Types of ankle sprain

Three ankle ligaments are susceptible to trauma:

• inferior tibio-fibular ligaments:
  • these ligaments, in conjunction with the interosseous membrane, prevent lateral displacement of the fibula and lateral drift of the talus during dorsiflexion
  • usually accompanies severe injury to the ankle, often with fracture
  • treatment involves stabilisation of the tibia and fibula by a screw from one bone to the other
    
    
• lateral ligaments:
  • the lateral ligaments consist of three parts, any one of which can be damaged by sprains, but especially inversion injuries
  • compromised lateral ligaments permit the talus to move relative to the tibia and fibula, possible resulting in chronic instability
  • operative repair is not performed acutely in the UK
  • late repair repair is not possible - the usual treatment being tenodesis e.g. the Dilwyn-Evans procedure
    
    
• medial ligaments:
  • the fan-shaped medial deltoid ligaments are far stronger than their lateral counterparts, hence stress here tends to pull the medial malleolus off of the shaft of the tibia
  • reduction of the ligament and bone may be required