Ruptures of the lateral ligaments of the ankle. Clinical diagnosis

During the 11-month period 1 October 1977 to 31 August 1978 a total of 44 patients with acute supination trauma of the ankle were examined. The clinical findings were compared with the results of arthrography. This revealed that direct and indirect tenderness of the anterior talofibular ligament and calcaneofibular ligament respectively, combined with a greater than or equal to 4 cm swelling anteriorly and over the lateral malleolus, indicated a ligament injury with great likelihood. If some of the diagnostic signs are absent, most emphasis should be laid on the swelling over the lateral malleolus and on the direct and indirect tenderness of the calcaneofibular ligament. The talar-tilt test and examination for the drawer sign were of limited diagnostic value.