Diagnosis of Ankle Injuries

To the Editor.—  Edeiken and Cotler (240:1182, 1978) recently emphasized the importance of stress roentgenograms in diagnosing ligamentous tears in moderate to severe softtissue injuries of the ankle. The authors clearly described those types of ankle fractures that are associated with ligamentous tears and that therefore do not require stress roentgenograms. However, nonroentgenographic techniques of defining complete ligamentous tears were not considered. Since severe ligamentous tears can often be defined on the basis of physical examination alone,₁ attention should be given to both physical examination and simple roentgenograms before selecting patients for stress views of the ankle.To define complete tears of the tibiofibular ligament in severe eversion injuries of the ankle, one may examine the anterior surface of the leg between the midportion of the tibia and fibula. Acute swelling and tenderness in this region suggest a complete tear of the tibiofibular ligament. After tearing of the tibiofibular