Ankle Ligament Injury (medial)

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Patient Information

GP Information

Background Information

  • Usually respond best to conservative management
  • Advise patients that ligaments may take longer to recover than fractures
  • Patients typically present following trauma (ankle eversion) with pain distal to the medial malleolus

Investigation Guidelines

  • Apply the Ottawa Ankle rules in order to determine of the patient requires an ankle XR
  • An USS is indicated in the setting of instability and diagnostic uncertainty.
  • An MRI may help to grade severity and look for associated injuries.

Management Recommendations

The majority of ankle ligament injuries may be treated non-operatively with home exercises or physiotherapy Initial management includes;

  • Prescribe PRICE in acute injuries.
  • Avoid HARM for 72 hours following injury.
  • OTC ankle support.
  • Avoid sporting activity until fully recovered.
  • Physiotherapy referral after 6 weeks if symptoms have failed to settle

Referral Indications

  • Diagnostic uncertainty
  • Positive ottowa ankle criteria.
  • Inability to bear weight.
  • Need for physiotherapy
  • Inability to perform ADLs after 6 weeks
  • Results of diagnostics indicate specialist assessment required.
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