Ankle Lateral Ligament Injury Assessment

Original Editor - Mariam Hashem

Top Contributors - Mariam Hashem, Kim Jackson, Tarina van der Stockt, Jess Bell and Olajumoke Ogunleye

Introduction

High iccurance and reocurance rate and high rate if going into CIA

Clear management depends on clear Ax strategy

Assessment:

Initially you assess the MOI. If the athlete is not able to continue to play, a decision has to be made on safety and ability to continue the game.

2 weeks post injur: Ax of CAI (checklist)

Comlpete CAIT questionnaire

Ottawa rule- if needed Rx- if +ve seek medical referral

if ottawa is absent: we need to check on the athlete's ability to compete- check again in 2 wks for CAIT questionnaire

not able to compete: full Ax of injury

Subjective: MOI, identify cont. factors,

obejective: laxity, Ant drawer, talar tilt, syndesmosis, base line for swelling, isometric eversion/abduciton and cumberland

++ laxity- medical

Ottawa rules:

Staight forward: if positive, refer for medical/radiological Ax

1-Tenderness on plapation of :

A-posterior edge/dip of lateral malleoulus

B-Posterior edge/dip of medial malleoulus

C-Base of 5th metatarsal

D-Navicular

Image?

2-Inability to fully weight bear for normal 4 steps at time of injury or on examination

Laxity tests:

ANterior drawer

talar tilt

Syndesmosis Testing:

Squeeze test

dorsi flexion-external rotation test

Cumberland ankle instability tool (CAIT)- cut off 11.5 > unlikely to progress . less: high likely to progress

Chronic ankle instability checklist:

identifies afailed outcome of rehabilitation following an ATFL injury and increased risk of developing CAI.

ROM markers:

WB ankle DF < 34 degrees

Strength markers:

isometric hip abduction strength <34% of body weight

Balance-stability markers:

Single-leg balance test <10 seconds and on toes < 5 seconds