Acute and chronic lateral ankle ligament injuries are quite common in daily life. As the body’s center of gravity rolls over the ankle

the injury in lateral ankle sprains usually occurs with forced plantar flexion and inversion of the ankle. The anterior talofibular ligament (ATFL) followed by the calcaneofibular ligament (CFL) are the most commonly injured ligaments. Nonsurgical measures

including functional rehabilitation

are the major management for acute injuries. Chronic lateral ankle instability is multifactorial. Failed nonsurgical management after appropriate rehabilitation is an indication for surgery. Of the many surgical options available

anatomic repair of the ATFL and CFL is recommended when the quality of the ruptured ligaments permits. Anatomic reconstruction with autograft or allograft should be performed when the ruptured ligaments are attenuated. Ankle arthroscopy is an important adjunct to ligamentous repair and should be performed at the time of repair to identify and address intra-articular conditions associated with chronic ankle instability.