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Supination trauma. A classic case.

G Möllenhoff1, J Richter1, G Muhr1

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Summary
This summary is machine-generated.

Lateral ankle ligament injuries are common. Differentiating between ligament elongation and complete rupture is crucial for effective treatment of ankle sprains and associated instabilities.

Keywords:
Key words Ankle sprain • Functional therapy • Clinical examination

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Biomechanics

Background:

  • Lateral ankle ligament sprains are the most frequent ligamentous injuries globally.
  • The primary mechanism involves foot supination, leading to antero-lateral rotational instability (ALRI).
  • Current classification systems (mild, moderate, severe) may lack practical clinical differentiation.

Purpose of the Study:

  • To emphasize the clinical relevance of distinguishing between ligament elongation and complete rupture in ankle sprains.
  • To highlight the biomechanical consequences of lateral ligamentous trauma, specifically ALRI.
  • To advocate for a comprehensive clinical examination beyond the distal fibula.

Main Methods:

  • Retrospective clinical study analysis (Zwipp, 1235 patients).
  • Review of common ligamentous and bony structures involved in ankle sprains.
  • Emphasis on clinical examination protocols and diagnostic imaging.

Main Results:

  • Complete disruptions frequently involve anterior talo-navicular and fibulo-calcaneal ligaments (70%).
  • Syndesmotic injuries occur in up to 10% of ankle sprains; deltoid ligament injuries in 2.5%.
  • Associated injuries along the 'supination fracture line' are reported in 7.4% of cases.

Conclusions:

  • Clinical assessment must include screening of the fifth metatarsal base, calcaneo-cuboideal ligament, anterior calcaneal process ligaments, talus, and syndesmotic ligaments.
  • Careful clinical examination and standard two-plane radiographs are deemed sufficient for diagnosing ankle sprains.
  • Accurate diagnosis facilitates appropriate functional therapy for optimal recovery.