A young man lands awkwardly after a jump, inverting his plantarflexed foot. He develops marked swelling and tenderness just anterior to the lateral malleolus. Which ligament is most likely torn?

• A Deltoid ligament
• B Posterior talofibular ligament
• C Calcaneofibular ligament
• D Anterior talofibular ligament ✓

Explanation

The commonest ankle injury is inversion of a plantarflexed foot, which places maximal strain on the anterior talofibular ligament, the weakest component of the lateral collateral complex. Tenderness anterior to the lateral malleolus localises the tear there. The calcaneofibular ligament is injured less often and usually together with the ATFL in severe sprains. The posterior talofibular ligament is very strong and rarely torn except in dislocation, and the deltoid ligament is injured by eversion forces.

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

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