Thanks Steve.

In the case where ATFL and its bony attachment at the tibia is avulsed, as it heals, would there be scar tissue between that bony fragment and the tibia? Often we see old injury where there is bony fragment within the mid substance of ATFL, would you say there is non-reunion with the tibia? How would you describe this in your worksheet?

A healing ATFL would show decreasing vascularity over time. What might it look like if there is non-effective healing on a sprained ATFL?

I come across a patient with a chronically ruptured ATFL (he had 2 sprains in the past doing martial arts) and recent posttraumatic synovitis at the anterolateral gutter. A 4mm bony ossicle at the anterior ankle joint. As I dorsiflex his foot, there is reduced movement with end range dorsiflexion pain. Would you call this anterolateral impingement based on both clinical & US findings?

Best regards,

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