Lateral ankle sprains: evaluation and treatment

The increased exposure of podiatric physicians to emergency room trauma, especially lateral ankle injuries, necessitates immediate knowledge to evaluate and treat this complex injury. The appropriate knowledge necessary includes the ability to recognize normal anatomy and variants from pathologic states, either osseous or soft tissue; the ability to perform specialized tests and their relationship to the clinical state; and, lastly, the ability to have at grasp various treatment modalities and the experience to initiate the proper treatment plan. The intent of this paper is, therefore, to present: normal anatomy of the lateral ankle and possible anomalies; mechanism of injury of lateral ankle sprains; performance of specialized tests, especially stress roentgenographs and arthrograms with examples of normal, normal variants, and abnormal findings; and a review of the literature of the present state of treatment, as well as the experience at our institution. Additionally, the authors hope to arrest the thought that a lateral ankle sprain is a simple soft tissue injury.