Ankle Sprains and Chronic Ankle Instability
Ankle sprains are most commonly successfully treated non-operatively. At times, if the ligaments do not heal appropriately, recurrent sprains or pain are a problem and non-operative treatment fails, surgery may be an option.
Ankle sprains are extremely common injuries and usually occur when the ankle twists or rolls due to a fall, misstep, or athletic injury. The ligaments on the outside (lateral) of the ankle are often torn or stretched due to the injury.
Pain, swelling, and bruising are common after these injuries. These are usually present on the lateral side of the ankle but can aslo be present on the inside (medial) of the ankle. The severity of the injury usually dictates the amount of symptoms. Xrays are usually obtained in order to ensure that a fracture is not present. In certain types of sprains involving the syndesmosis of the ankle (often referred to as a “high ankle sprain”) the sprain can cause instability of the ankle which is more significant than the average sprain. At times, Xrays of the opposite or uninvolved ankle are needed to compare and evaulate for subtle instability.
If these injuries are inadequately treated or recurrent, chronic instability of the ankle may develop. This occurs because the ligaments normally providing ankle stabilty did not heal properly and they become stretched or completely torn. This causes repeated propensity for recurrent sprains, giving out, or rolling the ankle with minimal trauma such as walking on uneven ground.
After an acute ankle sprain, rest, ice, elevation, and some form of immobilization (brace, boot, or cast) are used to alleviate symptoms. Once symptoms resolve over several weeks to months. Physical therapy is usually initiated to strengthen the stabilizing muscles of the ankle and improve range of motion and balance. Often a brace may need to be worn for athletic activities for a variable amount of time once the patient resumes these types of actities.
If the initial injury involves the syndesmosis of the ankle and significant Instability was present, surgery is required to restore the stabilty and allow the ligaments to heal. Screws and/or strong non-absorbable suture material are often used for this type of repair.
Ankle sprains are most commonly sucessfully treated non-operatively. At times, if the ligaments do not heal appropriately, recurrent sprains or pain are a problem, and the above mentioned non-operative treatment fails, surgery may be an option. This is usually considered only after many months have passed after the initial injury and the non-operative treatment has not been effective. This is termed chronic lateral ankle Instability. The goal of surgery is to repair or reconstruct the injured or torn ligaments and restore the stability of the ankle joint. Your surgeon will discuss the various surgical options with you. Post-operatively, a cast or brace is worn for several weeks, weight bearing on the leg is usually allowed, and physical therapy is needed.