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Ultrasonographic Anterior Talofibular Ligament Thickness Does Not Predict Functional Outcomes After Acute Lateral
Seung Myung Wi1, Dong Hee Kim1, Sang Heun Kim1
1Department of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
Journal of Foot and Ankle Research
|July 20, 2026
Summary
Ultrasonography showed the anterior talofibular ligament (ATFL) remodeled after ankle sprains, but its thickness did not correlate with patient recovery. Ligament healing may not be fully indicated by thickness alone.
Area of Science:
- Orthopedics
- Sports Medicine
- Radiology
Background:
- Ultrasonography is frequently used to assess acute lateral ankle sprains.
- The clinical relevance of ligament thickness changes during healing is not well understood.
- This study investigates the link between anterior talofibular ligament (ATFL) thickness and functional outcomes.
Purpose of the Study:
- To determine if changes in ATFL thickness correlate with functional recovery after acute lateral ankle sprain.
- To evaluate the association between ATFL structural remodeling and clinical outcomes.
Main Methods:
- Retrospective analysis of 32 patients with acute lateral ankle sprain treated conservatively.
- Serial ultrasound examinations measured ATFL thickness at baseline and 3, 6, 12 weeks post-injury.
- Functional outcomes assessed using VAS, AOFAS, and CAIT scores at 12 weeks.
Main Results:
- ATFL thickness ratio significantly decreased over 12 weeks, indicating healing.
- Significant improvements were observed in all functional outcome measures.
- No significant correlation was found between ATFL thickness ratio and functional outcomes at any time point.
Conclusions:
- Serial ultrasonography reveals ATFL remodeling after acute lateral ankle sprain.
- ATFL thickness alone does not appear to predict short-term functional recovery.
- Further research is needed to understand the full clinical significance of ultrasonographic findings in ankle sprain healing.
