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Ankle Sprains


The ankle joint is formed by three bones, the tibia, fibula, and talus. The bones are held together by several strong ligaments, which provide stability to the ankle joint. A sprain is a tear, or injury to a ligament, of varying severity.


Common Causes

Twisting injuries to the ankle. Seen with rapid pivoting in soccer and basketball. Stepping off of a curb or step can twist or rotate the ankle. Depending on the direction the foot is twisted, different ligaments can be injured.



Pain in the ankle, varying from mild to quite severe. Often there is swelling, especially in the outside of the ankle. Walking and weight bearing may be difficult, with pain and feelings of instability.


Physical Findings

Tenderness over ligaments of the ankle. Swelling may be noted. Stress of the involved ligaments is quite uncomfortable.



History, physical examination, and x-rays are usually adequate to make the diagnosis. Occasionally, special stress x-rays are used to determine chronic instability.


Non-operative Treatment

Treatment depends on the severity, or grade of the sprain. For mild, or grade 1 sprains, support until symptoms resolve. Moderate, or grade 2 sprains are treated with functional bracing, for several weeks. Severe, grade 3 sprains may require immobilization in a cast or brace to heal.


Surgical Treatment

Ligament repair or reconstruction.


Injury Comment

Surgery is rarely indicated for an acute ankle sprain, except perhaps in the high-performance athlete. Ligament repair is effective for chronic instability.