The Foot and Ankle Clinic

Ankle sprain

What is an ankle sprain?   |  The ankle ligaments injured by an ankle sprain  |  What else can be injured?   |  What symptoms might I have with an ankle sprain?   |  How common is a sprained ankle?  |   What is the difference between an ankle sprain and an ankle ligament rupture?   |  What treatments are available for a sprained ankle?   |  Which is the best treatment for an ankle sprain?   |   What sort of ankle brace to use for an ankle sprain?   |  Functional rehabilitation after ankle sprain   |  What is the expected natural history after an ankle sprain?  what if it doesn't get better?  When would an operation be appropriate?   |  What operations are available to stabilise the ankle?   |   Does the ankle ever "give" the other way (the foot facing outwards, rather than inwards)

What Is The Difference Between An Ankle Sprain and an Ankle Ligament Rupture?

An ankle ligament sprain means that despite being injured the lateral ankle ligament complex is competent and able to stabilise the ankle. An ankle ligament rupture means that the ligament ends are no longer in continuity so the ligament cannot stabilise its joint. This is a far less common occurrence.

It should be appreciated that the lateral ankle ligamentus complex is not the only things which stabilises the ankle joint. The ankle joint is also stabilised by the stability of its bony margins as well as the neighbouring peroneal tendons. It is possible that after a complete rupture the ankle ligaments will heal themselves back into a stable configuration and not leave problems with instability. It is also possible that if they are not able to heal in stable position by training the peroneal muscles appropriately the ankle joint may once again become stable. This is the basis of physiotherapy functional rehabilitation after an ankle ligament injury.

detached ATF ligament - proximity to peroneal tendons

A picture showing the proximity of the detached ATF ligament(1) to the
Peroneal tendons(3). The ankle joint has been opened.

Especially in the early stages after an ankle sprain, it can be difficult to diagnose whether the lateral ankle ligaments are simply sprained or whether the lateral ankle ligaments are ruptured. It may be logical to assume that a complete lateral ligament rupture should do less well in the longer term but evidence of this is lacking.

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