Ankle sprains are one of the most comoninjuries in sports. Although frequently considered benign injuries, up to 70% of these cases remain with residual complaints and around 1/3 undergo surgical treatment.

The structure that is most commonly enrolled is the lateral ligament complex. Initial treatment usually is functional immobilization, unloading and physiotherapy, with a good outcome, specially in mild injuries.

Complex injuries, such as the present case, associated to bone avulsion and injury of the deltoid ligament, have a worse prognosis with com conservative treatment.

It is important to analyse injuries that may be associated to ankle sprains, beyond lateral, medial and syndesmotic ligament injuries. Peroneal tendon ruptures (left) peroneal tendons instability (right), condral/osteochondral lesions, among others, are frequent lesions that may pass undiagnosed if not excluded.