Ankle Ligament Stabilisation
What is an Ankle Sprain?
A sprain is the stretching or tearing of a ligament. Ligaments connect adjacent bones in a joint and provide stability to the joint.
An ankle sprain is a common injury and occurs when you fall or suddenly twist the ankle joint or when you land your foot in an awkward position after a jump. It most commonly occurs when you participate in sports or when you jump or run on a surface that is irregular.
Ankle sprains can cause pain, swelling, tenderness, bruising, and stiffness, numbness in the toes, and inability to walk or bear weight on the ankle accompanied by persistent discomfort.
Inadequate healing of a sprained ligament or incomplete rehabilitation of the affected ligament can result in instability of the ankle.
A complete medical history, including a history of any previous ankle injuries, and a physical examination is essential for an accurate diagnosis of the condition. An X-ray may be ordered to confirm the diagnosis.
What are the Treatment Options for an Ankle Sprain?
Acute injuries can be managed with conservative treatment measures such as RICE method (rest, ice, compression and elevation), medications, bracing, and physical therapy.
Surgical intervention to reconstruct the injured ligament may be considered in patients with a high degree of instability and in those who have failed to respond to non-surgical treatments.
Ankle Ligament Reconstruction Procedure
The aim of surgery is to stabilise the ankle by repairing or reconstructing the damaged ligaments. Restoring normal ankle joint biomechanics helps to prevent damage to the joint from recurrent sprains, and ultimately minimise the risk of post-traumatic ankle arthritis.
Ankle lateral ligament repair surgery is performed though a small curved incision over the tip of the fibula. The torn ligaments are identified, shortened and repaired to their anatomical position on the fibula. This is usually achieved using bone anchors and strong sutures. Once the ligaments have been repaired solidly, the incision is sutured up and a local anaesthetic block is given to provide pain relief after the procedure.
Patients with other ankle joint problems such as joint surface damage (chondral or osteochondral lesions), synovitis, bone spurs or loose bodies in association with ankle instability may also require an ankle arthroscopy performed at the same time as the ligament repair.
At the end of the operation, a bulky dressing is applied and the leg is placed in a walking boot or plaster.
The surgery is usually performed as a day procedure.
Dressings should remain dry and intact until review by Dr Maor two weeks after surgery. The boot is usually worn for two weeks, and a brace may be required for several weeks thereafter. Physiotherapy rehabilitation is a very important part of the post-operative recovery, and is usually started at two weeks once the wound has healed.
Time to return to work and sport is dependent on the type and severity of any associated ankle joint problems, as well as the type of work or sport. Dr Maor will be able to evaluate this and provide some guidelines prior to surgery.
What are the Risks and Complications of Ankle Ligament Reconstruction?
Specific complications of ankle ligament reconstruction include infection, nerve damage, ankle joint stiffness, and recurrent instability.