How do you know when to seek treatment for an ankle ligament tear? Understand the symptoms, causes, and effective treatments for this common injury. Discover when surgical intervention may be necessary and how Capital Orthopaedics can help.

Understanding Ankle Ligament Tears

Ankle ligament tears, also known as ankle sprains, are one of the most common injuries among adults. The bones of the ankle are supported and mobilized by a series of ligaments, tendons, and muscles. When you roll over on your ankle, these supportive structures can get stretched, partially torn, or even completely torn.

Symptoms of an Ankle Ligament Tear

If you have torn your ankle ligament, you may experience the following symptoms:

• Swelling around the ankle joint
• A feeling of instability
• Bruising, sometimes extending up the lower leg and into the foot
• Tenderness to the touch
• Pain when putting weight on the ankle
• A popping sound at the time of injury

When to Seek Treatment for an Ankle Ligament Tear

If you are unable to put any weight on your foot 20 minutes after the injury has occurred, you should go to the emergency department. An x-ray will help rule out any fractures in the ankle bones. However, it won’t show the extent of the soft tissue damage.

For less severe ankle sprains, most people will treat them at home. But it’s important to consult with a specialist within a few days to assess the severity of the injury. If the symptoms of pain, swelling, and bruising haven’t reduced or you experience ongoing instability after the injury, you should get in touch with a specialist.

Treating Ankle Ligament Tears

The treatment for an ankle ligament tear depends on the extent of the injury. A partial tear can often be treated effectively with physiotherapy, which can help build up the muscles around the ankle to improve stability and prevent re-injury. A full tear, however, may require immobilization in an Aircast boot for three weeks.

Injection therapy can also be used to reduce inflammation after a ligament tear, and in some cases, surgery may be recommended if the tear has caused damage to other ankle structures or resulted in long-term instability.

The Role of Capital Orthopaedics

The team at Capital Orthopaedics is highly experienced in diagnosing and treating ankle ligament tears. They use a range of diagnostic tools, including physical examinations, MRI scans, and ultrasound, to assess the extent of the injury and develop a tailored treatment plan.

Whether you require non-surgical treatment, such as physiotherapy or injection therapy, or surgical intervention, the specialists at Capital Orthopaedics can provide the care you need to get you back on your feet and prevent long-term complications, such as ankle arthritis.

Protecting Your Ankles: Preventing Future Ligament Tears

If you have suffered an ankle ligament tear in the past, it’s important to take steps to prevent future injuries. This may include:

• Performing exercises to strengthen the muscles around the ankle
• Using ankle braces or supports during physical activity
• Gradually increasing the intensity and duration of physical activity to avoid overuse injuries

By taking these preventative measures and seeking prompt treatment for any ankle ligament tears, you can help protect your ankles and maintain your active lifestyle.

Frequently Asked Questions

What is the difference between an ankle sprain and an ankle ligament tear?

An ankle sprain is a general term that refers to any injury to the ligaments, tendons, or muscles around the ankle joint. An ankle ligament tear is a specific type of ankle sprain where one or more of the ligaments that connect the bones of the ankle have been partially or completely torn.

How long does it take to recover from an ankle ligament tear?

The recovery time for an ankle ligament tear can vary depending on the severity of the injury. A partial tear may heal in 2-4 weeks with proper treatment, while a complete tear may take 6-12 weeks or longer to fully heal.

Can an ankle ligament tear cause long-term problems?

Yes, if an ankle ligament tear is left untreated or doesn’t heal properly, it can lead to long-term issues such as chronic ankle instability, arthritis, and an increased risk of future sprains or tears.

When Should You Seek Treatment for An Ankle Ligament Tear?

You twist your ankle – perhaps doing something as innocuous as stepping off a kerb, perhaps running on uneven ground or in the middle of a game of football – and feel instant pain. A cursory search on the internet will tell you that you should treat a sprained ankle with an ice pack, anti-inflammatories like ibuprofen and keeping your foot elevated to reduce pain and swelling. You may also be a fan of arnica to reduce the bruising.

But how do you know when to seek medical advice?

If you are unable to put any weight on your foot 20 minutes after the injury has occurred, you’re advised to go to A&E. An x-ray will rule out any fracture in the bones of your ankle. But it won’t show the extent of the soft tissue damage.

For less severe ankle sprains, the majority of us will treat them at home. There are some issues with leaving an ankle sprain untreated, though. The supportive structures around your ankle can get stretched, suffer micro-tears, or be torn out of the bone altogether, potentially leading to long-term instability and other issues such as arthritis.

If you’ve had an ankle sprain, you should consult with a specialist within a few days to assess the severity. If the symptoms of pain, swelling and bruising haven’t reduced or you experience ongoing instability after the injury, you should get in touch with a specialist.

To understand why it is important to seek orthopaedic or sports medicine treatment for a sprained ankle, it often helps to understand how the structures of your ankle can get damaged and what effect that can have if you leave it untreated.

What is an Ankle Ligament Tear?

Sprained ankles are one of the most common injuries among adults.

The bones of your ankle are supported and mobilised by a series of ligaments, tendons and muscles. The four ligaments connect the bones, while tendons link muscles to bones.

When you roll over on your ankle, the supportive structures will naturally get stretched.

Ligaments, unlike tendons, are not very stretchy, so they are more likely to get torn. They can be pulled clean out of their anchor point in the bone, or partially or completely torn.

A ligament tear can affect the movement of your ankle joint, and impact on other structures. It’s not uncommon for bone fractures and cartilage damage to occur at the same time as an ankle sprain.

What Are the Symptoms of an Ankle Ligament Tear?

If you have torn your ankle ligament, symptoms include:

• Swelling around your ankle joint
• A feeling of instability
• Bruising – sometimes up your lower leg and into your foot
• Tenderness to touch
• Pain when putting weight on your ankle
• Popping sound at the time of injury

When Should I Seek Treatment for an Ankle Ligament Tear?

If any of these symptoms occur, you should seek treatment from a specialist. Also, if you have suffered a sprained ankle in the past, and persistently ‘go over’ on your ankle, it’s likely that you have chronic ligament damage.

It is really important to get treated sooner rather than later, as chronic instability and weakened ankles can lead to other more serious conditions, such as ankle arthritis.

How is an Ankle Ligament Tear Treated?

Any treatment of an ankle ligament tear starts with a thorough diagnosis. This usually includes a physical examination to test your range of motion, stability and ability to weight bear and to review the history of the injury.

An MRI or an ultrasound scan may be used to assess ligament or other soft tissue damage, and an x-ray may also be necessary to check for a fracture.

Depending on the extent of the injury, treatment options include:

Non-surgical

A partial ankle ligament tear can be treated effectively with physiotherapy. You will be given exercises to help build up the muscles around your ankle. This will improve stability and help prevent re-injury.

A full tear, though, will require immobilisation in an Aircast boot for three weeks.

Targeted massage can help stimulate blood flow to improve healing, reduce the build-up of fluid and reduce thickening caused by scar tissue.

Injections

Capital Orthopaedics offers injection therapy to reduce inflammation after a ligament tear.

Surgery

Surgery is usually only recommended if the ligament tear has caused damage to other structures of your ankle, or has resulted in long-term instability or the risk of other conditions such as arthritis.

Ligament tears can be surgically repaired by stitching them back together, re-attaching them to the bone, or replacing them with a graft (a tendon from another part of your body or from a donor).

Most ankle ligament surgery is carried out using keyhole (arthroscopic) surgery.

How Can Capital Orthopaedics Help with a Torn Ligament?

The team at Capital Orthopaedics is highly experienced at diagnosing and treating all ankle injuries.

Our consultant orthopaedic surgeons, led by internationally renowned surgeon Simon Moyes, work with top sports medicine professionals, physiotherapists and an in-house radiologist to ensure that you get the right diagnosis and most effective treatment.

All of the treatment plans are designed around your personal needs and lifestyle – whether you’re a professional sportsperson, a busy parent or an older person wanting to maintain your mobility.

Our aim is to get you back to your sports and everyday life with the least intervention, in the quickest time possible, and the lowest chance of re-injury or ongoing problems.

If you have injured your ankle and are suffering from ongoing symptoms, contact the team at Capital Orthopaedics here for more information or to book an appointment with one of our musculoskeletal experts.

Frequently Asked Questions

Can You Walk with a Torn Ligament in Your Ankle?

Yes, you can usually walk with a torn ligament thanks to the other ligaments and supporting structures, but you may feel a lot of pain and a sensation of weakness and instability as you walk. Will a full tear, you can walk with an Aircast boot.

How Long Does It Take to Recover from a Torn Ankle Ligaments?

This depends on the extent of the injury, whether you have other related damage, and whether you have surgery.

It can take anything from a few weeks to several months – depending on the tear (partial or complete), and the amount of physiotherapy you are able to do.

If you have had an ankle ligament repair, you may be able return to high impact sports after 4 to 6 months.

Do Torn Ankle Ligaments Require Surgery?

Many torn ankle ligaments recover well with a short period of rest, ice, compression and elevation (RICE), followed by a physical therapy programme focussed on building the strength around your ankle and improving mobility or an Aircast boot for complete tears.

In more severe cases, such as a complete rupture, or if there is bone or cartilage damage, surgery may be necessary to restore strength and stability.

Magnetic resonance imaging of ankle ligaments: A pictorial essay

Indian J Radiol Imaging. 2018 Oct-Dec; 28(4): 419–426.

doi: 10.4103/ijri.IJRI_77_16

Author information Copyright and License information Disclaimer

Ankle trauma is commonly encountered and is most often a sprain injury affecting the ligaments. Accurate diagnosis and appropriate treatment rest on knowledge of complex ligamentous anatomy of ankle and the entire spectrum of pathologies. Magnetic resonance imaging (MRI) is the imaging modality of choice for diagnosing ligament pathologies because of its multiplanar capability and high soft tissue contrast. With MRI, it is possible to triage and attribute the cause of post traumatic ankle pain to bone, ligament, or tendon pathologies, which otherwise overlap clinically. In this pictorial essay, emphasis is given to the intricate and unique anatomy and orientation of ankle ligaments. Pathologies of ankle ligaments have been elaborated.

Keywords: Ankle ligaments, magnetic resonance imaging, sprain, tear

Ankle is a complex mechanism consisting of two joints: the true ankle joint and the subtalar joint. The true ankle joint is composed of three bones, seen from the front: tibia medially; fibula laterally; and talus inferiorly. The true ankle joint is responsible for dorsiflexion and plantar flexion of the foot. Below the true ankle joint is the subtalar joint, composed of calcaneum inferiorly, and talus superiorly. The subtalar joint is responsible for inversion and eversion of the foot.

The two joints are supported and maintained by ligaments, each connecting two bones and the tendons. Injury to the ankle joint is a common emergency and usually a sprain related to sports, walking, fall, or road traffic accident. In ankle sprain, ligaments are frequently injured in association with bone fractures, avulsion, and contusions.

Imaging protocol

The sequences and parameters for optimal high resolution images are described in .

Table 1

Imaging protocol

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There are three major groups of ligaments supporting the ankle joint: lateral, medial or deltoid (superficial and deep component) and syndesmotic.

Sketch diagrams representing these groups are shown in Figures and .

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Lateral ligament complex: Anterior and posterior talofibular ligaments (yellow color) and calconeofibular ligament (blue color). Syndesmotic ligaments: Anterior and posterior inferior tibiofibular ligaments (pink color)

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Medial deltoid ligament complex: Superficial deltoid: Tibiocalcaneal ligament (orange color), Tibionavicular ligament (pink color). Deep deltoid: Anterior and posterior tibiotalar ligaments (blue color)

Lateral ligaments

Anterior talofibular ligament (ATFL), Posterior talofibular ligament (PTFL), and Calcaneofibular ligament (CFL) [Figure and ]. Use of oblique coronal plane (CFL view) helps in better evaluation of anatomy and pathology (injury) of CFL as compared to orthogonal plane.[1]

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Lateral ligaments: Anterior talofibular ligament and posterior talofibular ligament best identified on axial images, where talar dome (T) is oblong, fibula (F) is ‘C’/crescent shaped. Normal anterior talofibular ligament (pink arrow): Anterolateral tip of lateral malleolus to the neck of talus. Commonly injured. Normal posterior talofibular ligament (blue arrow): Malleolar fossa of lateral malleolus to lateral tubercle of talus. Intracapsular, extrasynovial, strongest, deepest, and least injured of lateral ligaments. Normal calcaneofibular ligament (yellow arrow): Tip of lateral malleolus to trochlear eminence of calcaneum, medial to the peroneal tendons (green arrow), and adjacent to the calcaneum (C)

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Sagittal proton density fat-saturated image showing anterior talofibular ligament (ATFL): Orange arrow and posterior talofibular ligament (PTFL): Yellow arrow. F: Fibula and T: Talus

Normal thickness of ATFL is 2 – 3 mm, and CFL is 2 mm.

Medial or deltoid ligaments

Superficial component of deltoid ligament

Tibiocalcaneal ligament (TCL), Tibionavicular ligament (TNL), and Tibiospring ligament (TSL) [Figures and ].

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Superficial deltoid ligament (Tibiocalcaneal ligament, Tibionavicular ligament, and Tibiospring ligament): Arise from anterior colliculus of medial malleolus, span two joints, have variable bone attachments distally, and hence, named accordingly. Normal Tibiocalcaneal ligament (red arrow) attaches to the sustentaculum tali of calcaneum (ST- C) and lies medial to tibialis posterior tendon. Tibialis posterior tendon – green arrow. Normal Tibionavicular ligament (blue arrow) attaches to the medial aspect of tuberosity of navicular bone (N), it crosses ankle and talonavicular joints

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Normal Tibiospring ligament (yellow arrow) is the only component of superficial deltoid ligament with no distal bone attachment, it merges with the superomedial (SM) component of spring ligament (blue arrow). The superomedial component of spring ligament is attached to the sustentaculum tali of calcaneum (ST- C). Tibiospring ligament lies medial to the Tibialis posterior tendon (pink arrow). The Tibiospring ligament, superomedial component of spring ligament complex and Tibialis posterior tendon have synergistic action in maintaining the medial plantar arch

Deep component of deltoid ligament

Anterior tibiotalar ligament (ATTL) and Posterior tibiotalar ligament (PTTL) [].

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Deep deltoid ligament: arise from intercollicular groove of medial malleolus of tibia, cross only one joint, intra articular and surrounded by synovium. Normal anterior tibiotalar ligament (ATTL: red arrow) is thin, striated, and attaches to the anterior aspect of body of neck of talus bone (T). Normal posterior tibiotalar ligament (PTTL: yellow arrow) is thick, striated, and attaches to the posterior most aspect of medial tubercle of talus bone (T)

Normal thickness of TNL is 1–2 mm, and TSL is 2 mm (1–4mm). The PTTL is thickest ligament and normally measures 6–11 mm.

Syndesmotic ligaments

Anteroinferior tibiofibular ligament (AITFL), Posteroinferior tibiofibular ligament (PITFL), Interosseus membrane or ligament (IOL), and Inferior transverse (ITL). Of these AITFL and PITFL can be easily identified on routine MRI []. Anterior and posterior inferior tibiofibular ligaments are injured simultaneously.[2] A 45° oblique plane is superior in demonstrating their normal integrity/pathologies as compared to orthogonal imaging. [3] Fluid in Tibiofibular recess normally measures 5–7 mm.

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Normal anterior (green arrow) and posterior (yellow arrow) inferior tibiofibular or syndesmotic ligaments are best identified on axial images, where the talar dome (T) is square shaped, and Fibula is round

In addition to these, the ankle is supported by the spring ligament. The spring ligament complex consists of superomedial (SM), medioplantar oblique (MPO), and inferoplantar longitudinal (IPL) components [Figures and ]. Normal thickness of SM component is 3 mm (2–5 mm), and IPL component is 4 mm (2–6 mm).

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Spring ligament complex includes the Superomedial, Medioplantar, and Inferoplantar longitudinal components. Normal superomedial component of the spring ligament: From sustentaculum tali (pink arrow) to superior and posteromedial aspect of navicular bone (blue arrows). In association with tibiospring ligament, it primarily stabilizes talocalcaneonavicular joint and secondarily stabilizes medial plantar arch of foot. Tibialis posterior tendon tendinosis (yellow arrow)

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Normal medioplantar oblique component of the spring ligament (yellow arrow): From coronoid fossa of calcaneum (C) to tuberosity of navicular bone. Normal inferoplantar longitudinal component of the spring ligament (red arrow): From coronoid fossa of calcaneum (C) to beak of navicular bone

Ligaments connect two bones; have higher proteoglycan and water content and less collagen. Normal ligaments are seen as uniform low-intensity band on T1 and T2 W images.[4] Notable exceptions include posterior talofibular, deep components of the deltoid ligament, and anterior inferior tibiofibular ligament that show heterogeneous signal and striations because of the interspersed fat between their fascicles.

Following acute injury the ligament undergoes repair in three stages. The first three days are characterized by inflammation, interstitial edema, and hemorrhage. The third to fifth days represent stage of repair with proliferation of fibroblasts. The second to fourth weeks are the stage of remodeling with formation of collagen. Periarticular edema is seen up to the seventh week.

MRI shows blurred margins, irregular contours, discontinuous/wavy/lax fibers, inhomogeneous signal, or loss of normal hypointense signal within the ligament. Certain ligaments such as PTFL, deep components of the deltoid ligament, and AITFL show loss of normal striations due to presence of edema and hemorrhage. The ligament may be attenuated, thick, thin, or elongated.

Acute ligament injuries can be graded as interstitial, partial, or complete tear.

Interstitial tears

Hyperintense signal within the ligament on PD and T2W images due to presence of edema or hemorrhage [].

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Interstitial tear of anterior tibiotalar ligament (green arrow) and posterior tibiotalar ligament (yellow arrow): Hyperintense signal seen within these ligaments due to the presence of edema or hemorrhage

Partial tears

Partial discontinuity of ligaments reaching up to the surface but not involving the entire thickness of ligament [].

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Partial tear of superomedial component of the spring ligament (green arrow): Seen as partial discontinuity, not involving the entire thickness of ligament. Associated tibialis posterior tendinosis (yellow arrow)

Complete tears

Discontinuity involving the entire thickness of ligament and is seen as fluid filled defect and retraction [Figures and ]. Joint effusion and obliteration of adjacent fat planes can be seen.

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Complete tear of Calcaneofibular ligament (yellow arrow): Seen as discontinuity involving the entire thickness of ligament. Associated peroneal tendinosis (red arrow) and contusions of calcaneum (green arrow)

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Complete tear of anterior talofibular ligament (green arrow): Seen as discontinuity with retraction of the ligament. Associated fluid seen in the anterolateral gutter. Posterior talofibular ligament is intact (yellow arrow). Talus bone (T)

Ankle sprain contributes to 20–40% of sport injuries. [5] Depending on the mechanism of injuries, particular group of ligaments are injured.

Inversion injury accounts for 85% of ankle sprain and is commonly seen with high velocity sports such as basketball, soccer, and football.[5,6] Inversion injury commonly affects the lateral ligament complex. Of these, ATFL being the weakest is more prone to injury[7,8] []. Injury to ATFL is less common at the talar attachment because of the denser fibrocartilage and greater bone density than that of the fibular attachment.[9]

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Inversion injury: Complete tear of anterior talofibular ligament (green arrow): Seen as discontinuous ligament. Also seen is partial tear of Posterior talofibular ligament (pink arrow) with edema and loss of striations. Associated fluid in the anterolateral gutter

Eversion injuries commonly affect the medial deltoid ligament complex, accounting for approximately 5% of ankle sprains and are associated with sports such as gymnastic, rugby, and soccer. [10,11]

High ankle/syndesmotic sprains account for 7% of routine ankle sprains and 40% of injuries in athletes. These are more often seen in association with sports such as football, ice hockey, soccer, skiing, running, and jumping.[12,13] Fluid in the tibiofibular recess measuring >12 mm is definitely abnormal and suggestive of acute injury to syndesmotic ligaments or high ankle sprains[14,15] [].

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High ankle sprain: Fluid in the tibiofibular recess measures approximately, 10 mm (green arrow) with torn anterior and posterior inferior tibiofibular/syndesmotic ligaments (blue and pink arrows, respectively). Normal tibiofibular recess measures 5–7 mm, approximately

MRI shows an attenuated, thin – hypoplastic, or alternately a thick – hyperplastic ligament with irregular contours and absence of edema or hemorrhage.

Anatomical variations of the ligaments alter joint mechanics, thus, making the individual prone to repeated injuries and chronic instability. [16] Anterolateral and medial impingement syndromes are the result of such chronic repetitive stress; these can be adequately diagnosed on MRI.

In chronic ATFL tear, granulation/scar tissue or fibrosis in the anterolateral gutter resembles a “meniscus” and can lead to clinical anterolateral impingement syndrome []. Similar findings can be seen in anteromedial and posteromedial impingement syndromes [].

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Anterolateral impingement syndrome: Chronic partially healed tears of anterior talofibular ligament (green arrow), posterior talofibular ligament (blue arrow), and calcaneofibular ligament (yellow arrow). Soft tissue in the anterolateral gutter (pink arrows) with synovial hyperplasia represents ‘meniscus’

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Medial impingement syndrome: Chronic partially healed tears of the anterior tibiotalar ligament (yellow arrow) and posterior tibiotalar ligament (pink arrow). Soft tissue in the anteromedial gutter (green arrows) with hypertrophic synovium represents ‘meniscus’. TIB: Tibia, F: Fibula, T: Talus

Post contrast fat-suppressed 3D-FSPGR (3D fast spoiled gradient echo recalled acquisition in the steady state) sequence of the ankle is superior and accurate in assessing anterolateral impingement syndrome by better delineation of synovial thickening/inflammation and granulation tissue.[8]

Ligaments and adjacent tendons have synergistic functions, and their injuries are most often simultaneous. Peroneal tendinosis is commonly seen with ATFL injury followed by CFL and PTFL injury[17] []. Partial longitudinal tear of peroneus brevis tendon is commonly associated with lateral ankle sprain.[18] Tibialis posterior tendon injuries are seen simultaneously with tibiospring and spring ligament complex injuries because of their synergistic action in maintaining the medial plantar arch[19,20] [Figures and ]. Bone contusion, osteochondral lesion, and joint effusion are other common associations [].

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Synergistic action of tibialis posterior tendon, tibiospring ligament, and superomedial component of the spring ligament complex in maintaining the medial plantar arch. Partial tear of tibiospring ligament (pink dotted line and arrow), sprain of superomedial component of spring ligament (gray curved line and green arrow). Tibialis posterior tendinosis and partial interstitial tear (black arrow). Normal flexor digitorum longus tendon (yellow arrow). M: Medial malleolus of Tibia, ST-C: Sustentaculum tali of calcaneum, T: Talus

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Bone contusions in medial malleolus (MM), joint effusion, and Tibialis posterior tendinosis (yellow arrows) associated with tear involving the deep Deltoid – posterior tibiotalar ligament (red arrow) and superficial Deltoid – tibiocalcaneal ligament (orange arrow) and tibiospring ligament (green arrow). T: Talus

Knowledge of anatomy and imaging appearance of normal and abnormal ankle ligaments on MRI with an understanding of biomechanics of injury aids in achieving accurate diagnosis and appropriate treatment of ankle sprains. Depending on the MRI features and the clinical co-relates (Drawers test, inversion and eversion tests), it is possible for the clinicians to grade the ankle injury from mild to severe and also assess instability. Most of the ankle sprains are stable and are treated conservatively (rest, immobilization, ice compression, and elevation). Those associated with osteochondral lesions are treated with arthroscopic repair. Severe ankle sprain injuries with instability are treated with surgical reconstruction of ligaments.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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Ankle instability. Ankle Ligament Reconstruction

1. How do ankle injuries occur?
2. Symptoms of torn ligaments
3. How is the diagnosis carried out?
4. Complications after injury
5. Treatment of the ankle joint after a torn ligament
6. How long is the treatment at the Gelenk Clinic?

External ligaments connect the fibula (Fibula) to the calcaneus and talus. Intertibial syndesmosis runs between the tibia and fibula. © Gelenk Clinic

Ligament reconstruction of the ankle joint is a chronic instability operation. This instability leads to ankle dislocations at the slightest load. In this case, there is increased mobility of the ankle itself, which is a greater load on the articular cartilage, which usually leads to its destruction.

How do ankle injuries occur?

Torn ankle ligaments are often caused by falls or injuries while playing sports. Ligaments lose their stabilizing function and patients can no longer move as they used to. Most often, external ligaments are damaged. The anterior talofibular ligament is injured in almost all injuries of the lateral ligaments.

Risk factors such as being overweight, wearing the wrong footwear, or being physically unfit can cause a tear or strain.

medical inquiry

Ligament tear symptoms

Injuries to the external lateral ligaments are manifested by severe pain and the formation of hematomas. © Leo, Fotolia

If a person twists their foot, the subsequent ankle pain and swelling are typical symptoms that are mistaken for a simple sprain and do not go to a doctor. Hematomas may also appear due to rupture of the saphenous veins. Other symptoms are ankle pain and the inability to lean on the leg. As a rule, an injury leads to a decrease in the ability to withstand the load, which can persist for several days, and sometimes weeks.

If the victim cannot stand on his leg at all, then most likely a complete rupture has occurred.

How is the diagnosis carried out?

Ankle ligament repair © Viewmedica

In addition to specially prepared questions and examinations, X-rays help the Gelenk Clinic specialist to rule out bone damage. In this case, it is necessary to take into account not only fractures, but also ruptures with bone fragments or injuries of the tibiofibular syndesmosis (bone fusion from connective tissue). Since an X-ray examination shows the state of the bone structures, but does not show the ligaments, we recommend taking a so-called held image, where the doctor examines the dissection of the joint space in comparison with the opposite side. Thus, it is possible to distinguish a simple stretch from a rupture. Such records are made using a special support apparatus and standard pressure. In some cases, an additional survey . The patient is referred for an MRI or ultrasound. These techniques can also detect soft tissue injuries.

Complications after injury

Timely diagnosis of “fresh” injuries and consistent treatment usually have a good prognosis. These lesions usually take four to six weeks to heal.

However, problems are caused primarily by ligament instability in the ankle, which weakens the limb. This means that a person can quickly twist their leg. Approximately 10% of all patients with external ligament injuries have chronic instability.

Repetitive trauma contributes to articular cartilage deformities. Since the articular cartilage is not able to withstand shear loads for long, you should contact the doctors of the Gelenk Clinic in Germany until arthrosis develops.

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Treatment of an ankle joint after a torn ligament

Treatment depends on the extent of the injury. If endoprosthesis is planned, then an examination of the ankle is carried out arthroscopically. During this operation, the condition of the cartilage is checked and the remnants of the torn ligament are removed.

When ligaments are torn, various surgical methods are used. The goal of all ankle reconstruction surgeries is to achieve ankle stability.

Usually a positive result is achieved after about 6 weeks. During this time, the patient needs to wear special orthoses to immobilize the limbs.

At the Gelenk Clinic , various plastic techniques are used. When plastic surgery of the external ligament, they try to restore it with the help of an implant from their own tissue. For this, residual elements, parts of the periosteum of the lateral malleolus and tissues of the articular capsule are used. If these tissues are insufficient, then tendon implants are used. To do this, parts that pass in close proximity to the external ligament are removed and then transplanted into the joint.

Surgeons of the Gelenk Klinik perform the reconstruction of the ankle joint in case of chronic instability according to the method Brostöm . In this case, the remaining elements serve for anatomical restoration. During the operation, they are collected and then stretched to reach the original length of the ligaments. To ensure stability, parts of the extensor tendons are moved towards the lateral malleolus and sutured.

How long is the treatment at the Gelenk Clinic?

After the operation, a special shoe is made for the patient. You must walk with crutches for 12 days until the wound heals. Within the next 3 weeks you will already be able to move without crutches, but in a special boot. After 4 weeks, the boot is relaxed so that you can bend and unbend your leg. After six weeks of treatment, it is possible to walk without a shoe. At this time, it is necessary to undergo intensive treatment to restore the muscles and mobility of the leg.

The staff of the Gelenk Clinic will be happy to advise you on all the necessary questions regarding the cost of the operation and postoperative treatment.

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Ankle ligament plasty: price