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Understanding the types of ankle sprains is essential in determining the most appropriate treatment and preventing substantial missed time from sports. Commonly known and recognized is an acute lateral ankle sprain, however, a differentiation should also be made to understand high (syndesmotic) ankle sprains as the mechanism of injury and recovery periods differ between these two types., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Clinical diagnostic tests objectively evaluate lower extremity ailments of the athlete. The positive squeeze test is found to be reproducible for ankle syndesmotic injury but is a poor prognosticator. The anterior drawer and talar tilt tests assess lateral ankle sprains. These have limitations secondary to positioning and guarding by the athlete, so comparison with the asymptomatic extremity is recommended. The Ottawa ankle rules assess possible fractures of the ankle and midfoot. The Thompson test evaluates Achilles tendon tears, whereas the windlass technique and the modified Lachman test examine the integrity of the plantar fascia and metatarsophalangeal joint capsule., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Many articles have been published that discuss various lateral ankle injuries and specific lateral ankle pathology. The purpose of this article is to explore and present a specific combination of findings that the author's multiphysician practice has noticed on a frequently recurring basis. The triple injury of ankle synovitis, ankle instability, and peroneal tendon tear can be termed the Lateral Ankle Triad. While it is common to find each of these specific injuries individually, they are often found in combination., (Copyright © 2011. Published by Elsevier Inc.)

Foot and ankle injuries are among the most common of all sports-related injuries. Many injuries are simplistic from a diagnostic standpoint, whereas others require a high level of suspicion and the use of appropriate diagnostic imaging modalities. Whether a professional athlete or a weekend warrior, all athletes want minimal disruption to their sporting activity and a quick return to competition. An accurate diagnosis aids in the development of an appropriate rehabilitation program and in return to activity. This article reviews the more common foot and ankle injuries seen in the podiatrist's office and the preferred imaging modalities used to evaluate them.

Care of the youth athlete requires knowledge of developmental anatomy and specific injury patterns, which are acute or chronic in nature. We may expect that the incidence of overuse and acute foot and ankle injuries in this population is likely to increase in proportion to the number and intensity of competitive youth teams with demanding training schedules. We, as physicians, must exercise our best judgment in regard to recognizing these patterns early and instituting appropriate treatments. Return to play decisions should be based on objective criteria when available and always keeping the best interest of the athlete's future health in the forefront of our minds.

Lateral ankle sprains are among the most common sports injuries. Although ankle sprains are treated conservatively at the present time, for years the treatment was based on acute repair of the ruptured ligaments. Several differing opinions currently exist as to the treatment of lateral ankle sprains. A review of the literature and explanation of the benefits and risks of each treatment protocol is undertaken.

Ligamentous injuries at the ankle and subtalar joint range from simple sprains to severe talar dislocations. While lateral ankle sprains are among the most frequently encountered injuries and do not pose a greater diagnostic problem, the surgeon must be suspicious not to overlook associated ligamentous injuries at the subtalar and midtarsal level that may result in chronic painful conditions. Syndesmotic instabilities with or without ankle fractures must be assessed carefully and treated properly, since these are prearthrotic conditions. In the treatment of chronic ankle or subtalar instability tenodeses provide mechanical stability while reducing subtalar mobility. Anatomic reconstruction methods therefore should be considered for both conditions.

Owing to the variability of injury, a mechanism of injury other than external rotation of the foot should not rule out a high ankle sprain. One must consider syndesmotic injury in the differential diagnosis of common ankle sprains and trauma. A high index of suspicion must lead the physician through clinical and radiographic examinations. Early and appropriate treatment of a high ankle sprain can greatly decrease a prolonged return to activity. Patients, especially competitive atheletes, must be educated regarding the morbidity of the condition.

The diagnosis and management of lateral ankle injuries require the physician to obtain an accurate history, complete a thorough physical examination, and institute appropriate treatment protocol. Labeling all acute lateral ankle injuries as ankle sprains can lead to long-term mechanical and functional instability and chronic pain around the ankle. Appropriate and aggressive functional rehabilitation of the acute ankle limits the postinjury convalescence and need for surgical reconstruction. If surgical repair of the chronic or acute ankle is warranted, the Brostrom-Gould procedure serves as a highly successful anatomic repair. Lateral ankle tenodesing procedures also are effective; however, in most cases, the loss of rearfoot motion limits this procedure to a secondary reconstructive procedure.

Simple ankle sprains are common injuries. Failure to evaluate, diagnose, and adequately treat severe ankle sprains results in continued pain, instability, and decreased function. This article reviews the examination, stabilization procedures, physical therapy techniques, and complications of these injuries.

Arthroscopy of the ankle has a definite role in the diagnosis and treatment of intra-articular pathologic conditions. Topics discussed in this article include advantages and disadvantages of arthroscopy, patient evaluation, indications for diagnostic arthroscopy, and techniques and considerations of office-based arthroscopy. Four case studies supplement the text.

Meniscoid lesions and fibrous bands are unique lesions, most likely of differing origin. Although they are similar in clinical presentation, their appearance at arthroscopy is clearly different. The meniscoid lesion is attached only at its origin at the inferolateral gutter on the anterior talofibular ligament. Fibrous bands are attached at two ends and may be found anywhere in the joint but are most common extending dramatically over the anterior joint line. Unexpected encountering of a fibrous band should alert the surgeon to carefully inspect the joint for other associated (occult) pathology. Because of the frequent association of bands with antecedent fracture, the observation of this lesion should lead the clinician to consider antecedent intra-articular fracture (transchondral fracture, malleolar fracture, and tibial pilon fracture) as a likely co-pathology. Careful examination of the ankle and review of the radiographs and other available images may be helpful in assessing the joint for these injuries when fibrous bands are encountered. The association of meniscoid lesion with prior soft tissue injury (sprain) is also important to understanding this lesion. Excision of both these abnormal lesions in concert with repair of coexistent pathology is associated with improvement of symptoms. Finally, both fibrous bands and meniscoid lesions are associated with symptoms that warrant closer inspection and observation. Whether the operative intervention is open or closed, the reader can benefit from the information presented.

As has been previously discussed, the incidence and resultant associated disabilities of ankle sprains have been well documented in the literature. The staggering statistics on long-term disability show that there is no such thing as a simple ankle sprain. The degree of disability is related to the extent of the initial injury as well as the follow-up medical care provided. It is this fact that requires a complete understanding of the injury as well as a proper treatment and rehabilitation program. One of the reasons cited for the long-term disability or lack of consistently good results in treating ankle sprains is the lack of uniformity in treatment. One possible reason is the lack of agreement in diagnostic techniques as well as the end diagnosis of a particular grade of ankle sprain. If a sprain is managed correctly, resultant disability will be kept to a minimum. A proper rehabilitation program may be the most important factor in preventing chronic instability. The acronym RICE falls short of complete ankle management. RICE primarily addresses the ankle edema. Thus, the patient's ankle is only partially rehabilitated. A rational approach to the management of ankle sprains is given. Upon reviewing a complete protocol for ankle sprain rehabilitation, the acronym TEMPER can be used judiciously to remember the key steps in the treatment plan. Through the use of this acronym, one can institute a complete rehabilitation program.