Liz Bayley

Liz Bayley

10-02-2023

17:32

Complex lateral ankle sprain ⚠️ Mini thread 🧵 Watch the left foot carefully… 👉🏼🦶🏼🦶🏼 🔹Grade 2 lateral ankle sprain 🔹Bifurcate ligament sprain 🔹5th MT avulsion fracture 🔹Calc compression fracture Consent ✅ 1/5

Anterior Draw Test was positive, suggesting damage to the ATFL fibres, but Talar Tilt test (CFL) was normal = Grade 2 lateral ankle sprain. There’s still no consensus on the best classification system 👇🏼 2/5

Bifurcate lig. attaches the calc to the cuboid/navicular. The mechanism of injury was plantarflexion > inversion which explains the injured ATFL, but a relatively intact CFL. This MOI will sometimes = anterior process of calc #. In this case it was only a bifurcate sprain 3/5

5th MT avulsion fracture is a sometimes missed complication of a PF/IV injury. The peroneal muscle group pulls a small piece of bone from the base of the 5th metatarsal. It usually takes around 6 weeks to heal. 4/5

In high force injuries like this, you have the lateral damage from the stretched tissues, but there’s also a significant compressive force at the medial sub-talar (and T/C) joint. This caused a calcaneus fracture in this patient which was diagnosed after a CT scan 🦶🏼 5/5



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