Lateral Ankle Instability
Chronic Ankle Instability / Ankle Sprains
Suggested ORF Modifications
ICD 10 - R: M25.371 / L: M25.372
Ankle sprains occur when the ligaments that support and stabilize the area are injured due to excess stretching and possible tearing. Patients may report this injury having occurred as a twisting of their ankle. Severe strains can make it likely for recurrent ankle strains and pains in the future. The majority of ankle sprains occur in the lateral or outward facing ligaments of the ankle. The degree of severity of an ankle sprain depends on the degree of tearing that occured in that ligament:
- Grade 1: Overstretched ligament fibers and minor microtearing
- Grade 2: Partial ligament tearing and excess ankle looseness
- Grade 3: Complete ligament tearing and significant ankle instability
Ankle sprains are also differentiated by the ligaments sprained. The more common ankle sprains occur with injury to the anterior talofibular ligament and the calcaneal fibular ligament.
High ankle sprains are a different class of ankle sprains which occur in the ligaments that connect the tibia and fibula. The ligaments involved in high ankle sprains are the anterior inferior tibiofibular ligament, the posterior inferior tibiofibular ligament and the deltoid. Tearing of the deltoid during injury may also lead to the breaking of the fibula.
- Instability of the ankle
Clinicians will physically examine the problem area to assess the degree of ligament damage, ankle instability and other possible fractures. X-rays and other imaging studies may be used to rule out any possible fractures and tendon tears.
In the vast majority of cases, surgery is not a requirement. Grade 1 and Grade 2 sprains require only Rest, Ice, Compression and Elevation. NSAIDs are also useful to reduce pain and inflammation. Grade 3 strains may require crutches, a cast-boot and physical therapy in addition to RICE. High ankle sprains require much more time to heal from, and physical therapy should be done when possible.