Ligament ➠The stability of a joint is increased by the presence of a joint capsule of connective tissue, thickened at points of stress to form ligaments. The ends of the ligament attach to bone.

 Ligament injuries range from mild injuries involving the tearing of only a few fibers to complete tears of the ligament, which may lead to instability of the joint. Ligament injuries are divided into three grades .

➤Grade I sprain render some stretched fibers but clinical testing reveals normal range of motion on stressing the ligament. 

➤Grade II sprain involves a sizeable proportion of the fibers and, therefore, stressing the ligament and stretching of the joint show increased laxity but a definite end point.

➤Grade III sprain is a complete tear of the ligament with excessive joint laxity and no firm end point. 

Although they are often painful conditions, grade III sprains can also be pain-free becouse of  sensory fibers are completely divided in the injury. The management of acute ligament sprain is summarized in . The initial management consists of first aid to minimize bleeding and swelling .

➥ For Grade I and II sprains, treatment 

➽Goal to promote tissue healing

➽Prevent joint stiffness

➽Protect against further damage 

➽Strengthen muscle

➽Muscle to provide additional joint stability

➧The healing of collagen in a partial ligament tear takes several months. However, depending on the degree of dam age, return to sport may be possible sooner than this especially with protection against further injury.

➥ Treatment of a grade III sprain ➨ may be either conservative or surgical. For example, the torn medial collateral ligament of the knee and the torn lateral ligament of the ankle may be treated conservatively with full or partial immobilization.

 Alternatively, the two ends of a torn ligament can be reattached surgically and the joint then fully or partially immobilized for approximately six weeks. 

In certain instances (e.g. anterior cruciate ligament rupture), torn ligament tissue is not amenable to primary repair and surgical reconstruction of the ligament, usually using tendon, may be performed instead.