Anatomy · Lower Limb Anatomy (Nerves, Vessels, Joints)

During an inversion ankle sprain evaluation, a student notes that the medial side of the ankle has a broad triangular ligament attaching the medial malleolus to the navicular, calcaneus, and talus. A forced eversion injury typically does not tear this ligament because it is extremely strong. What happens instead?

  • A The fibula is fractured above the intact syndesmosis
  • B The medial malleolus is avulsed
  • C The calcaneofibular ligament ruptures first
  • D The spring ligament is stretched
Correct answer: B. The medial malleolus is avulsed

Explanation

The deltoid (medial) ligament of the ankle is so strong that excessive eversion usually avulses the medial malleolus at its attachment rather than tearing the ligament itself. The calcaneofibular and anterior talofibular ligaments are lateral structures injured in inversion sprains, not eversion, which eliminates options A and C as answers to this mechanism.

Reference: Gray's Anatomy for Students, 4th ed.

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