Low vs. High Ankle Sprains Quiz

Low vs. High Ankle Sprains

• Mechanism of Injury (MOI): Low ankle sprains involve inversion and plantar flexion, while high ankle sprains result from tibial external rotation and/or dorsiflexion.
• Structures Affected: Low ankle sprains typically affect the anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL), and calcaneofibular ligament (CFL). High ankle sprains involve the syndesmotic ligaments.
• Prognosis: Low ankle sprains have a shorter recovery time (1 week) compared to high ankle sprains (15-46 days, 2-7 weeks).
• Chronic Ankle Instability (CAI): Approximately 40% of low ankle sprains progress to chronic ankle instability, characterized by chronic pain, recurrent instability, recurrent episodes of giving way, and loss of function.

Chronic Ankle Instability (CAI)

• Pain Impairments: Ligamentous and capsular pain, reduced performance, reflex inhibition, pain during weightbearing and joint movement outside of the open packed position.
• Mobility Impairments: Hypermobility of the talocrural joint and impairments in joint play. Specific tests include anterior drawer test and talar tilt test.
• Movement Coordination Deficits: Impaired neuromuscular control, postural control, diminished activation of peroneus longus and tibialis anterior during movements. Transition between single- and double-limb stance is affected.
• Muscle Performance Deficits: Weakness in ankle evertor muscles, and diminished activation of hip muscles (gluteus medius and maximus).

Ankle Sprain Grades

• Grade I: Minimal loss of function, no ligamentous laxity, little to no hemorrhage, minimal point tenderness, slight decreased ankle motion (≤5°).
• Grade II: Moderate loss of function, positive anterior drawer test (ATFL involvement), negative talar tilt test (CFL not involved), moderate hemorrhage, moderate point tenderness, decreased ankle motion (5-10°).
• Grade III: Marked loss of function, positive anterior and talar tilt tests, marked hemorrhage, severe point tenderness, and significant decreased ankle motion (>10°).

Ottawa Ankle Rules

• To determine if ankle X-rays are needed.
• Palpating the malleolar and midfoot zones for any tenderness.
• Assessing weight-bearing ability.
• Indications for X-ray include any bone tenderness at the specified areas and the inability to bear weight immediately after injury or in the emergency department.

Test your knowledge on the differences between low and high ankle sprains. This quiz covers mechanisms of injury, affected structures, prognosis, and chronic ankle instability. Understand the implications of ankle injuries and their recovery times.