In inverted ankle sprain, which ligament is typically the first to sustain damage?

• A. Posterior talofibular ligament
• B. Deltoid ligament
• C. Anterior talofibular ligament
• D. Calcaneofibular ligament

Answer: (C)

Inversion ankle sprains stress the ligaments on the outer side of the ankle, and the first structure to give is the anterior talofibular ligament. This ligament is most taut when the foot is in plantarflexion and inverts, making it the weakest and most easily torn with a sudden inward roll. As the injury progresses in more severe cases, the calcaneofibular ligament may also tear, and less commonly the posterior talofibular ligament can be involved. The deltoid ligament on the inside is not typically affected in an isolated inversion sprain unless there’s a different mechanism (eversion injury) or high-energy trauma.