ABSTRACT
Medial ankle ligament injuries usually occur in combination with syndesmosis injuries, or ankle fracture-dislocations, and less frequently in isolation. In this chapter, the authors provide an overview covering the management of both acute and chronic lateral ligament injuries, syndesmosis injuries and medial ankle sprains. Most deltoid ligament injuries occur in association with high energy ankle fractures or syndesmotic injuries, when the talus is forced into either external rotation or abduction. Clinical examination of an acute ankle injury should initially follow the Ottawa ankle rules to rule out a fracture. Radiographs should be taken to rule out a Maisonneuve type injury if there is proximal fibula tenderness and also to exclude Tillaux-type or posterior malleolar avulsion fractures, which can be present in up to 50% of such injuries. Deltoid ligament injuries frequently occur in association with ankle fracture dislocations or high-grade syndesmosis injuries. There is medial swelling and palpation may help differentiate a deltoid ligament injury from a spring ligament injury.
