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Deltoid Ligament Sprain

Deltoid Ligament Sprain. What is a Deltoid Ligament Sprain?. A sprain of the deltoid ligaments with an eversion mechanism The deltoid ligaments are Posterior tibiotalar ligament Tibiocalcaneal ligament Anterior tibiotalar ligament Tibionavicular ligament.

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Deltoid Ligament Sprain

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  1. Deltoid Ligament Sprain

  2. What is a Deltoid Ligament Sprain? • A sprain of the deltoid ligaments with an eversion mechanism • The deltoid ligaments are • Posterior tibiotalar ligament • Tibiocalcaneal ligament • Anterior tibiotalar ligament • Tibionavicular ligament

  3. 5-10% of ankle sprains are deltoid ligament sprains • Also called an eversion ankle sprain • Less common because of ligamentous strength and structure • Avulsion fracture normally will occur before a sprain • Deltoid ligaments may be contused from an inversion ankle sprain because of the compression of the ligaments or impingement of medial malleolus

  4. Cause • Forceful sudden eversion of ankle • External blow to lateral leg with foot planted

  5. Sign and Symptoms • Pain with ROM of ankle mostly in eversion • Tenderness over the medial side of ankle • Swelling • Ecchymosis • Instability • Inflammation • Gross deformity with a grade 3 • Inability to bear weight

  6. Examination • Eversion stress test • Single heel raise • Evaluation of other ligamentous structure • ROM • Talar Tilt • Squeeze test • Bump Test • Bounce Percussion test

  7. Classification • Grade 1- Mild partial tear -Mild or no instability -Mild Pain -Little swelling -Some joint stiffness

  8. Grade 2- More of a severe Partial Tear - Moderate instability - Moderate to severe pain - Swelling - Stiffness in joint

  9. Grade 3- Complete tear - Gross instability - Severe to no pain - Severe swelling

  10. DiagnosticTesting • X-ray to rule of fracture • Use of ottawa rules for x-rays needed to be taken to help rule out x-rays not needed

  11. Treatment • Healing takes longer than an inversion ankle sprain • Untreated sprains may lead to a pes plantus deformity • If a fracture is ruled out than treatment is similar to an inversion ankle sprain but you would want to limit eversion ROM • Ice • Compression • Elevation

  12. Anti inflammatories • Contrast bath in later stages to help reduce swelling if needed • Jobst pump

  13. Rehab • ABC’s • Wobble board • Theraband exercises • Heel to toe walking • Heel raises • Balance exercises • Bike Be sure to check eversion ROM for pain free ROM

  14. Return to Play • Pain free ROM walking and running • Deltoid tape job • Ankle brace

  15. References • Gallaspy, J.B. May Signs and Symptoms of Athletic Injuries. Mosley Inc., St.Louis 1996, p.375 • Arnheim, Daniel, Prentice, W.E. Principles of Athletic Training. McGraw Hill: Boston 10th ed. 2000 p.494 • www.aafp.org/20010101/93.html • www.tausportsmedicine.com/ottawa2htm. • www.google.com/deltoidligament.com

  16. Thanks!!

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