From the Guidelines
The most common ligaments involved in lateral ankle sprains are the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL), with the ATFL being the most frequently injured. These ligaments are typically damaged in a sequential pattern, with the ATFL tearing first, followed by the CFL, and then the PTFL in severe cases. The ATFL is particularly vulnerable because it is the weakest of the three ligaments and is placed under tension during plantarflexion and inversion of the foot, which is the most common mechanism of injury in ankle sprains. The CFL becomes taut in dorsiflexion and provides stability to both the ankle and subtalar joints. The PTFL is the strongest of the three and is rarely injured in isolation, typically only becoming damaged in severe ankle injuries or dislocations. Understanding this anatomical arrangement helps clinicians properly assess and treat lateral ankle sprains, which account for approximately 85% of all ankle sprains, as noted in the studies 1. Key points to consider in the treatment and prevention of lateral ankle sprains include:
- The use of functional support devices such as tape or a brace in combination with an exercise programme for optimal recovery 1
- The importance of excluding fractures using the OAR, which has high sensitivity and specificity 1
- The preference for functional treatment over immobilisation, with surgery reserved for patients with lateral ligament ruptures 1
- The effectiveness of functional support and exercise therapy in preventing recurrent ankle sprains 1.
From the Research
Lateral Ankle Sprains
- The most common ligaments involved in lateral ankle sprains are the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL) 2, 3, 4, 5, 6.
Order of Injury
Ligament Complex
- The lateral ankle ligament complex (LLC) comprises the ATFL, CFL, and PTFL, which are interconnected and work together to stabilize the ankle joint 2, 5.