Introduction

A sprain is an injury to the band of collagen tissue i.e. a ligament, which

connects two or more bones to a joint. The primary function of a ligament
is to provide passive stabilisation of a joint and it plays an important role
in proprioceptive function. [1] A sprain is usually caused by the joint being
forced suddenly outside its usual range of movement and the inelastic
fibres are stretched through too great a range. For example, excessive
inversion of the ankle can cause the lateral ankle ligaments, primarily the
anterior talofibular ligament, to rupture. A severe sprain may look and feel
like a break (fracture), and it can be difficult for health professionals to tell
the difference between the two. [2] A ligament rupture can occur at the
midsubstance of the ligament or at the ligament-bone junction.
[1]
 Sometimes an avulsion fracture also occurs (the ligament pulls a piece of
bone with it on injury). The image shows an example of a sprain of the
ankle.

Grades of Injury
A sprain can range from mild (tearing of just a few fibres) to severe
(complete rupture of the ligament, leading to joint instability).

The severity of a sprain is graded according to how badly the ligament has
been damaged and whether or not the joint has been made unstable. The
joint can become unstable when the damaged ligament is no longer able to
give it the normal support [2]:

 Grade I - structural damage only on microscopic level, with slight local

tenderness and without joint instability. [1]
 Grade II - partial tear (rupture) of the ligament, visible swelling and
noticeable tenderness, but without joint instability (or with mild
instability).[1]
 Grade III - a severe sprain: complete rupture of the ligament with
significant swelling and with instability of the joint. [1]
Mild to moderate sprains are treated conservatively and normally heal after
6 weeks.