An ankle ligament injury, also known as an ankle sprain, can be caused by a sudden twisting movement of the foot during any athletic event or during daily activities. When stretched beyond its limit, the ligament may partially or completely tear. Scott J. Ellis, MD provides expert diagnosis and individualized non-operative and operative treatments for Stiff Big Toe in New York, NY. Contact Scott J. Ellis, MD’s team for an appointment today!
What are Ligaments?
Ligaments are made up of elastic tissues that interconnect bones to one another. They bind the joint together, providing stability and support to the joint. The ligaments protect the ankle joint from abnormal rotation and stabilize the joint during movement.
What is an Ankle Ligament Injury?
An ankle ligament injury, also known as an ankle sprain, can be caused by a sudden twisting movement of the foot during any athletic event or during daily activities. When stretched beyond its limit, the ligament may partially or completely tear. The injury can range from mild to severe, depending on the condition of the injured ligament and the number of ligaments involved.
What are the Causes of Ankle Ligament Injuries?
Ankle ligament injuries may be caused by a sudden twist, fall, a blow to the joint or any abnormal movement. Use of inappropriate shoes during physical activity or any forceful movement over an uneven surface may also cause a ligament injury. It is one of the most common orthopaedic injuries and can also be caused by walking down a slope. Previous ankle or foot injuries and congenitally weak ankles increase the propensity for an ankle sprain.
What are the Symptoms of an Ankle Ligament Injury?
Pain is the most common symptom of an ankle ligament injury and can be associated with swelling and bruising. Sometimes the joint may develop stiffness and you may have difficulty in walking. The symptoms of an ankle ligament injury depend on the severity of the injury which correlates with the extent of damage to the ligaments.
How is an Ankle Ligament Injury Diagnosed?
A thorough review of your history and complete physical examination by your physician will determine the degree and nature of the injury. Your doctor may move the ankle in different directions to evaluate the extent of the injury. This may be painful. X-rays may be ordered to confirm the severity of the injury and rule out the possibility of a fracture. In severe cases, an MRI scan may also be ordered.
What are the Treatment Options for Ankle Ligament Injury?
Ankle ligament injuries need immediate medical attention. If they are left untreated, they may cause chronic ankle instability. Conservative as well as surgical treatment may be advised for the management of ankle ligament injuries.
Conservative Treatments for Ankle Ligament Injuries
Conservative treatment may be recommended for immediate relief. The RICE therapy (rest, ice, compression, and elevation) reduces pain and swelling and provides rest to the injured ligament. Non-steroidal anti-inflammatory drugs (NSAIDs) may be recommended for the management of pain and inflammation.
Surgical Treatments for Ankle Ligament Injuries
Surgery is not commonly recommended for the management of an ankle sprain. However, if conservative treatments fail to provide relief and ankle joint instability persists even after months of rehabilitation, surgery may be required.
Common surgical procedures performed for the management of an ankle sprain include ankle reconstruction surgery and ankle arthroscopy.
Rehabilitation after Ankle Ligament Injury Treatments
After the non-surgical or surgical treatment, rehabilitation of the injured ankle is important. Physical therapy is effective for complete rehabilitation and includes strengthening exercises, mobilization exercises, and gait training. Physical therapy provides long-term benefits and can help prevent a recurrence of the injury.
Osteochondral Injury of the Ankle
What are Osteochondral Ankle Injuries?
The ankle joint is formed by the articulation of the end of the tibia and fibula (shinbones) with the talus (heel bone). Osteochondral injuries, also called osteochondritis dissecans, are injuries to the talus bone. It is characterized by damage to the bone as well as the cartilage covering it. Sometimes, the lower end of the tibia or shinbone may also be affected.
What are the Causes of Osteochondral Ankle Injuries?
Osteochondral injuries are most often caused by trauma to the ankle joint, such as with ankle sprains. Some cases may not have any previous history of ankle injury and may be caused by local osteonecrosis or a metabolic defect.
What are the Symptoms of Osteochondral Ankle Injuries?
The symptoms of osteochondral ankle injuries include:
- Localized pain of the ankle joint
- Tenderness and swelling of the ankle joint
- Difficulty in weight-bearing
- Locking of the ankle
How are Osteochondral Injuries of the Ankle Diagnosed?
Osteochondral injuries are diagnosed by a physical examination, and X-ray and CT and MRI scans. Plain X-ray images can reveal other fractures, bone spurs, and narrowing of the joint. A CT scan helps identify any bony fragments and cysts, but is not very helpful to visualize bone edema or cartilage defects. MRI is the best imaging modality, which helps to visualize the cartilage and bone lesions as well as bone edema.
What are the Treatment Options for Osteochondral Ankle Injuries?
Nonsurgical or surgical treatment may be recommended for the management of osteochondral injuries of the ankle joint.
Nonsurgical treatment with immobilization, restricted weight-bearing and physical therapy may be ordered to help the bone and cartilage to heal, and improve muscle strength, mobility and coordination.
Surgical treatment is recommended for severe injuries and comprises of debridement (removal) of the damaged cartilage and removal of any loose bodies. Some of the most commonly used surgical techniques include:
- Microfracture or drilling of the lesion
- Grafting of cartilage and bone
- Fixation of the fragments with the help of screws