Lateral ankle sprains: a comprehensive review - Part 1: etiology, pathoanatomy, histopathogenesis, and diagnosis

Ankle sprains are among the most common injuries sustained by athletes and seen by sports medicine physicians. Despite their prevalence in society, an kle sprains still remain a difficult diagnostic and therapeutic challenge i n the athlete, as well as in society in general. The purpose of this sectio n of our two-part study is to review scope of the problem, the anatomy and biomechanics of the lateral ankle ligaments, review the pathoanatomical cor relates of lateral ankle sprains, the histopathogenesis of ligament healing , and define the mechanisms of injury to understand the basis of our diagno stic approach to the patient with this common acute and chronic injury. We extensively review the diagnostic evaluation including historical informati on and physical examination, as well as options for supplementary radiograp hic examination. We further discuss the differential diagnosis of the patie nt with recurrent instability symptoms. This will also serve as the foundat ion for part two of our study, which is to understand the rationale for our treatment approach for this common problem.