Ankle Ligament Tear
Ankle ligament tear – ACUTE INJURY
One of the most common injuries is ankle sprain and ankle ligament tear.
Twisting the foot and ankle inward can lead to either
- a sprain of the ligamentous structures (Distorsio articulatio talocruralis)
- a ligament tear
- to a total rupture of the ligamentous structures (Subluxatio tali suppinatorium)
Ligament Tear Diagnosis
A pure ankle sprain is diagnosed clinically. This manifests as painful swelling of the ankle with stable joint conditions. The ligamentous structures are overstretched, but their continuity is maintained.
An X-ray is mandatory to rule out a bony injury.
If there is a ligament rupture, it is also diagnosed clinically. In addition to the X-ray, magnetic resonance therapy should be performed for further clarification of the extent of the injury. Additional injuries, such as cartilage damage, can also be clarified.
Ankle Ligament Tear Treatment
An ankle sprain can be treated conservatively, with a splint being prescribed for 4-6 weeks. Accompanying this, physical therapy should be performed to strengthen the outer ligament-strengthening muscles and mobilize the joint.
In the case of a ligament tear, depending on the clinically determined instability, a decision is made as to whether a conservative approach with 6 weeks of splint treatment or a surgical approach is indicated. In surgical therapy, the torn ligamentous structures are adapted with sutures in order to achieve stable ankle conditions after healing. Accompanying physical therapy is essential in both cases.
Ankle – Chronic instability
If there is chronic ligament instability of the ankle that does not improve with physical therapy stabilization, surgical stabilization should be performed in active patients.
Prior to this, radiological clarification must be carried out using standard X-rays, held X-rays in lateral comparison, and magnetic resonance imaging. If there is already a bony defect, an additional computed tomography scan is useful.
In surgical treatment, arthroscopy (joint endoscopy) is performed to identify and treat cartilage damage. Further stabilization depends on the severity of the instability. In some cases, mobilization and direct suture of the torn ligamentous structures in “mini-open” technique (Broström operation) is sufficient.
In severe cases of chronic instability, a ligament replacement must be performed. For this purpose, a tendon strip close to the ankle joint is removed and used as a new ligament for stabilization. Alternatively, a donor tendon can be selected.
