Here is the grading system for ankle sprains. Which one sounds most likely?
Grading — Ankle sprains have traditionally been classified based upon clinical signs and functional loss from grade I to grade III:
A grade I sprain results from mild stretching of a ligament with microscopic tears. Patients have mild swelling and tenderness. There is no joint instability on examination, and the patient is able to bear weight and ambulate with minimal pain. Due to their benign nature, these injuries are not frequently seen in the office.
A grade II sprain is a more severe injury involving an incomplete tear of a ligament. Patients have moderate pain, swelling, tenderness, and ecchymosis. There is mild to moderate joint instability on exam with some restriction of the range of motion and loss of function. Weight bearing and ambulation are painful.
A grade III sprain involves a complete tear of a ligament. Patients have severe pain, swelling, tenderness, and ecchymosis. There is significant mechanical instability on exam and significant loss of function and motion. Patients are unable to bear weight or ambulate.
Although higher grade sprains involve more severe injuries to ligaments, the time for healing is not always proportional to the grade of the sprain.
