The anterior talofibular ligament is a ligament in the ankle. It passes from the anterior margin of the fibular malleolus, anteriorly and laterally, to the talus bone, in front of its lateral articular facet. It is one of the lateral ligaments of the ankle and prevents the foot from sliding forward in relation to the shin. It is the most commonly injured ligament in a sprained ankle—from an inversion injury—and will allow a positive anterior drawer test of the ankle if completely torn. See also[edit]
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Sprains to the ankle are one of the most common sporting injuries. A sprain is defined as a tearing of the ligaments that connect bone to bone and help stabilise the joint. Sports requiring jumping, turning and twisting movements such as basketball, volleyball, netball and football; and explosive changes of direction such as soccer, tennis and hockey are particularly vulnerable to ankle sprains. Following an ankle sprain, the ankle joint may become unstable and take a long time to recover. AnatomyThe ankle joint is a hinge joint formed between the tibia and fibula (bones of the lower leg) and the talus (a bone of the foot), and allows the foot to bend upwards (dorsiflexion) and downwards (plantarflexion). The joint also allows a small amount of rotation. Two bones of the foot, the talus and calcaneus (heel bone) connect to form the subtalar joint which allows the foot to rock side to side (inversion/eversion). The joint’s stability comes from the structural arrangement of the bones and the surrounding ligaments. Ligaments provide stability by preventing the amount of side to side movement. On the inside of the ankle (medial side), the joint is stabilised by a thick, strong fibrous ligament called the deltoid ligament. Sprains to the deltoid ligament (eversion sprains, foot twists outward) account for less than 20% of all ankle sprains. On the outside of the ankle (lateral side), the joint is stabilised by three smaller ligaments; the anterior talofibular (at the front), the calcaneofibular (at the side) and the posterior talofibular (at the back). Sprains to any of these ligaments (inversion sprains, foot twists inward) account for more than 80% of all ankle sprains. The most commonly injured ligament is the anterior talofibular. Injury to this ligament results in swelling and pain on the outside of the ankle. If the force is more severe, the calcaneofibular ligament is also damaged. The posterior talofibular ligament is less likely to be damaged. A complete tear of all ligaments may result in a dislocation of the ankle joint and an accompanying fracture. Occasionally medial ligament injuries may be seen in conjunction with a lateral ligament injury. The inferofebular ligament can also be injured. Injury to this ligament can be a cause of prolonged recovery from a sprain. Ligament sprains to the ankle joint may also involve the ligaments between the tibia and fibula bones. These injuries may involve a fracture, are often slower to recover, and may require surgery. RiskAcute ankle sprains result from a force being applied to the ankle joint which causes excessive range of movement at the joint. Players are immediately aware of the condition and may hear an audible ‘snap’ or ‘pop’, due to the tearing or stretching of the ligaments. Proven risk factors
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Signs and SymptomsSprains are graded on a scale of 1 to 3 (mild, moderate, and severe), depending on the degree of tearing to the ligaments. In most cases, x-rays are performed to rule out a fracture or dislocation.
Immediate ManagementThe immediate treatment of any soft tissue injury consists of the RICER protocol – rest, ice, compression, elevation and referral. RICE protocol should be followed for 48–72 hours. The aim is to reduce the bleeding and damage within the joint. The ankle should be rested in an elevated position with an ice pack applied for 20 minutes every two hours (never apply ice directly to the skin). A correctly sized compression bandage should be applied to limit bleeding and swelling in the joint. The No HARM protocol should also be applied – no heat, no alcohol, no running or activity, and no massage. This will ensure decreased bleeding and swelling in the injured area. A sports medicine professional should be seen as soon as possible after the injury to determine the extent of injury and to advise on treatment and rehabilitation. In evaluating the injury, the sports medicine professional may order an x-ray or other testing to determine the extent of the injury. Rehabilitation and Return to PlayMost ankle sprains heal within 2 to 6 weeks, however severe sprains many take as long as 12 weeks. A comprehensive rehabilitation program minimises the chance of the injury recurring and includes flexibility, balance, stretching, strengthening and sport specific exercises. During this time, taping or bracing the ankle may be prescribed to provide support until full function is regained. If, while performing a rehabilitation exercise, ankle joint pain or discomfort is experienced, stop immediately and re-consult a sports medicine professional. Players with significant ligament injuries (Grade 2 or 3) are advised to use bracing or protective taping when playing sport for a minimum of 6 to 12 months post injury. AcknowledgementsSports Medicine Australia wishes to thank the sports medicine practitioners and SMA state branches who provided expert feedback in the development of this fact sheet. Images are courtesy of www.istockphoto.com Always Consult a Trained ProfessionalThe information above is general in nature and is only intended to provide a summary of the subject matter covered. It is not a substitute for medical advice and you should always consult a trained professional practising in the area of sports medicine in relation to any injury. You use or rely on the information above at your own risk and no party involved in the production of this resource accepts any responsibility for the information contained within it or your use of that information. How long does it take a anterior talofibular ligament to heal?ligament. Mild tenderness and swelling around the ankle, typically recovers in 5-14 days. Partial tearing of anterior talofibular ligament and some tearing of the calcaneofibular ligament. Moderate tenderness and swelling around the ankle, typically will take 2-3 weeks to recover.
How do you treat a sprained anterior talofibular ligament?Rehabilitation Program
Initial treatment of all grades of lateral ankle sprains consists of rest, ice, compression, and elevation (RICE), as well as nonsteroidal anti-inflammatory drugs (NSAIDs). Ice should be applied to the injured ankle for approximately 20 minutes, 3-4 times per day.
What is an anterior talofibular ligament sprain?The anterior talofibular ligament (also known as ATFL) is the most commonly injured ligament when the ankle is sprained on its outside or lateral aspect.
How do you treat anterior talofibular ligament ATFL?A non-operative 'functional treatment' programme includes immediate use of RICE (rest, ice, compression, elevation), a short period of immobilisation and protection with a tape or bandage, and early range of motion, weight-bearing and neuromuscular training exercises.
Can you walk with a torn anterior talofibular ligament?Small tears of the ATFL will cause pain, tenderness, and swelling, but walking is usually still possible. Larger ATFL tears will cause greater pain, swelling and bruising, and you may have difficulty walking.
What causes anterior talofibular ligament sprain?Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle.
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