foot ankle
Chronic Ankle Instability
intermediate
6 min
28 marks
6 questions
Clinical Scenario
A 28-year-old female netball player presents with recurrent right ankle sprains over 4 years since an initial severe inversion injury. She reports 6 significant giving-way episodes requiring time off sport in the past year, with persistent ankle pain and swelling after activity. She has completed supervised physiotherapy for 4 months without improvement. Clinical examination reveals anterior drawer test grade 2+ positive, talar tilt 12° (contralateral 5°), tenderness over the ATFL, and mild peroneal weakness. She has flexible joints throughout (Beighton 6/9).
Stress radiographs and MRI are provided.
Stress radiographs and MRI are provided.
Clinical image for Chronic Ankle Instability
Image source: Open Access medical literature (NIH/PubMed Central) • CC-BY License
Questions
Question 1 (4 marks)
Describe the anatomy of the lateral ligament complex. What is the mechanism and pattern of injury?
Question 2 (5 marks)
What is chronic ankle instability? Differentiate between mechanical and functional instability.
Question 3 (6 marks)
Describe your clinical assessment of this patient. What investigations would you order?
Question 4 (5 marks)
Outline the non-operative management. What are the indications for surgical intervention?
Question 5 (4 marks)
Describe the Broström-Gould procedure. What are the key technical steps?
Question 6 (4 marks)
When would you consider anatomic ligament reconstruction instead of repair? What graft options are available?