Ankle Sprain

Lateral Ankle Sprain Grades (Leach's Classification)

• Type1: ATFL affected
• Type 2: Complete tear of anterior talofibular lig and some damage of the CFL lig. 
• Type 3: Rupture of all 3 ligament, associated with rupture. 

O'Donoghue's Classification

1. Partial tear of LCL with mild swelling/tenderness, no mechanical instability, pt can walk, play.
2. Incomplete tear of LCL with moderate swelling/tenderness, mild/moderate instability, pt limps after injury. 
3. Complete tear of LCL with severe swelling/tenderness, echymosis, instability, pt cannot walk after injury. 

Dias Classification (1979)

Grade I: Partial rupture of CFL.
Grade II: Rupture of ATF
Grade III: Complete rupture of CFL, ATF and /or PTF.
Grade IV: Rupture of all lateral collateral ligaments and partial failure of the deltoid ligament. 

Anterior Drawer Test: Checks ATFL by pulling cal/talus forward while stabilzing tib/fib. 5-8mm drawer --> rupture of ATF, 10-15mm drawer-->rupture of ATF + CF, >15mm drawer --> rupture of ATF, CF+PTF. 

Talar Tilt: >10mm of inverstion is indicative of CFL rupture. 

Kleiger's Test: Rotate foot and dorsiflex to check for medial pain (deltoid) or anterolateral pain (syndesmosis). 

Tinel's Sign: Tapping PT nerve causes radiation in one direction.