Ankle Hyperinversion Injury: Most Commonly Injured Ligament

Mechanism and Epidemiology

• Inversion injuries of the ankle represent 25% of all musculoskeletal injuries and 50% of sports-related injuries 1
• The American College of Radiology reports that the anterior talofibular ligament (ATFL) is the most commonly injured ligament in ankle sprains caused by hyperinversion of the foot 1, 2

Clinical Relevance

• MRI studies demonstrate diagnostic accuracy of 77%-92% for detecting ATFL tears, with the ATFL being identified as torn far more frequently than other lateral ligaments 3, 4
• The American College of Radiology states that the anterior drawer test specifically detects ATFL injury by demonstrating excessive anterior displacement of the talus 2

Common Pitfall

• The American College of Radiology warns not to confuse lateral ankle sprains (inversion injuries affecting ATFL) with high ankle sprains (syndesmotic injuries from dorsiflexion-eversion-external rotation) 1, 2