Anterior drawer test
Tests anterior talofibular ligament
Cup heel with one hand and and pull anteriorly while pushing tibia posteriorly
Talar tilt test
Tests for combined injury of anterior talofibular and calcaneofibular ligaments
Inversion at the ankle causes tilting/lifting of the mortise joint
Tests anterior talofibular ligament
Cup heel with one hand and and pull anteriorly while pushing tibia posteriorly
Tests for combined injury of anterior talofibular and calcaneofibular ligaments
Inversion at the ankle causes tilting/lifting of the mortise joint
Ankle x-ray needed if:
Pain near the maleoli AND
Inability to bear weight immediately and in the ED (4 steps) OR
Tenderness at posterior edge or tip of lateral malleolus OR
Tenderness at posterior edge or tip of medial malleolus
Foot x-ray series needed if:
Pain in the midfoot AND
Inability to bear weight both immediately and in the ED (4 steps) OR
Tenderness at the navicular OR
Tenderness at the base of the 5th metatarsal
Age <6 or >55
Only for blunt trauma mechanism
Does not apply to subacute/chronic injuries
Does not apply to injuries of the hindfoot or forefoot
Grade I
No tearing of ligaments
Minimal pain, swelling, ecchymosis; weightbearing is tolerable
No splinting/casting; weight bearing as tolerated, isometric exercises, full ROM and stretching/strengthening exercises
Grade II
Partial ligament tear; possible instability
Increased pain, swelling, ecchymosis; difficulty bearing weight
Immobilize with air splint; PT with ROM/stretching/strengthening exercises
Grade III
Complete ligament tear; significant instability
Severe pain, swelling, ecchymosis; inability to bear weight
Immobilization and possible surgery; PT same as grade 2 but longer time period
No tearing of ligaments
Minimal pain, swelling, ecchymosis; weightbearing is tolerable
No splinting/casting; weight bearing as tolerated, isometric exercises, full ROM and stretching/strengthening exercises
Partial ligament tear; possible instability
Increased pain, swelling, ecchymosis; difficulty bearing weight
Immobilize with air splint; PT with ROM/stretching/strengthening exercises
Complete ligament tear; significant instability
Severe pain, swelling, ecchymosis; inability to bear weight
Immobilization and possible surgery; PT same as grade 2 but longer time period
Ankle sprain
Elbow dislocation
Ankle dislocation
Ankle syndesmosis injury
Humerus fracture
Radiograph-negative ankle injury 
Patella fracture
Tibial plateau fracture