Pediatric Orthopedic Surgeons treating Ankle Misalignment

ANKLE LAXITY

Chronic ankle laxity occurs when the ankle joint becomes loose or unstable following an injury or damage to the ligaments in the ankle. The ligaments normally hold the ankle together and keep it stable.

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Ankle Laxity

Ankle LaxityA ligament issue in your child’s ankle is known as ankle laxity. When the ankle joint becomes loose and unstable, it is usually the result of strained or torn ligaments. Also, ligaments are durable tissue bands that attach one bone to another to create joints. In addition, ankle laxity can also be referred to as ankle joint instability. Ankle injuries sustained in the past led to instability. Because of prior sprains and strains, the ligaments in the ankle cannot fully support the joint. The ankle has lost strength or the healing process was not complete.

The ankle is a joint that may move up and down as well as side to side.  Furthermore, it contains several ligaments in the foot and ankle. Regardless, the bones in the ankle and foot are held together securely by these sturdy bands-like structures. There are multiple ligaments on the outside of your foot. These include the calcaneofibular ligament and the anterior talofibular ligament (ATFL) (CFL). These aid in stabilizing the foot and ankle when a child walks. Ligaments may start to weaken and loosen if your child has sustained recurrent ankle sprains or if a child has certain foot abnormalities. An ankle may become unstable if this occurs.

Causes of Ankle Laxity

Injuries to the ligaments in your child’s ankle can lead to laxity in the ankle. A ligament injury can result in stretching, or partial or full tearing of the ligament. A ligament injury normally refers to a sprain. If an ankle joint has sustained several severe sprains or ligament tears, it loses part of its natural support and is more likely to twist or sprain

Ankle Laxity Symptoms

Symptoms may include:

  • A sensation that an ankle is unstable occurs when it buckles when twisting or bending
  • Recurrent pain
  • Swelling

QUESTIONS AND ANSWERS

What is Ankle Laxity?

Ankle laxity refers to excessive looseness or instability in the ankle joint, causing it to move beyond its normal range of motion. This can occur due to stretched or torn ligaments, weakening of the joint, or previous ankle injuries.

What are the symptoms of Ankle Laxity?

The common symptoms of ankle laxity include recurrent ankle sprains, a feeling of instability or “giving way” of the ankle, pain, swelling, and difficulty bearing weight on the affected foot. Individuals with ankle laxity may find it challenging to participate in physical activities and may experience chronic discomfort.

How is ankle Laxity Diagnosed and Treated?

Diagnosis of ankle laxity is typically made by a healthcare professional, such as an orthopedic surgeon or sports medicine specialist, through a physical examination, medical history, and imaging tests like X-rays or MRIs. Treatment for ankle laxity may involve non-surgical or surgical approaches based on the severity of the condition. Non-surgical methods include physical therapy to strengthen the ankle and improve stability, using ankle braces or supports during activities, and rest followed by rehabilitation after an ankle sprain. In cases of severe or recurrent instability, surgical intervention, such as ankle ligament reconstruction, may be recommended to repair and stabilize the affected ligaments and restore normal ankle function.

If your son or daughter is suffering with ankle problems, make an appointment with us

Diagnosis of Ankle Laxity

Your medical professional will evaluate your child and inquire about his or her symptoms, daily activities, and medical background. Your child can undergo X-rays or other scans. For instance, your child could have a stress X-ray, in which case your doctor would extend your child’s ankle while the X-ray is being taken. Your doctor will check to see if the pressure from the stretching causes the bones to drift apart.

Treatment

Your doctor will recommend ankle exercises that improve balance, strength, and range of motion. To support your child’s ankle, he or she might have to wear a brace. In addition, your doctor could suggest surgery to repair the injured ligaments, if the ankle remains loose and unstable. This will increase ankle stability and eliminate the sensation that the ankle is flimsy and about to give way. If your child does not receive treatment, your child’s ankle may continue to sprain and twist. Your child’s ankle joint may become permanently damaged as a result of these frequent twists. With self-care, the discomfort often goes away in a few weeks, although certain injuries may take several months or longer to recover. It’s crucial to exactly adhere to your doctor’s directions.

Non-Surgical Treatment

To reduce swelling and ankle pain:

  • Every three to four hours, for a maximum of 20 minutes at a time, place an ice pack, gel pack, or bag of frozen vegetables wrapped in a towel on the affected region.
  • Use over-the-counter pain relievers such acetaminophen, ibuprofen, or naproxen. Go over the label and follow the directions. Your child shouldn’t take these medications for more than 10 days unless your doctor advises you to.
  • Ibuprofen, naproxen, and aspirin are examples of nonsteroidal anti-inflammatory drugs (NSAIDs) that may induce gastrointestinal bleeding and other issues. Additionally, with aging, these dangers rise.
  • Acetaminophen may harm the liver or result in other issues. Children should not take more than 3000 milligrams (mg) in a day unless their doctor advises it. Check any medications your child takes to see whether they also include acetaminophen to be sure your child does not take too much.
  • When your child sits or lies down, keep his or her ankle up on a cushion.
  • As instructed by your clinician, use an ankle brace.

Surgery

If one or more of the ligaments on the outside of your child’s ankle have become loose or strained, surgery may be necessary. It can lead to persistent discomfort, frequent ankle sprains, and an ankle that frequently gives way when your child walks or engage in other activities. Your child’s ankle ligaments may first become partially torn and stretched as a result of an ankle sprain. Also, the chances of your child spraining his or her ankle again increase as a result of the initial injury. If your child’s initial sprain was not correctly treated, this is more likely to occur. Your child’s ligaments may become even laxer from additional sprains. Latitudinally reconstructed ankle ligaments can be done in a variety of ways. Inquire about the specifics of the procedure from your orthopedic foot surgeon. The procedure might last up to two hours. What to anticipate is as follows:

  • Your child will likely receive either a regional anesthetic to numb the affected limb or general anesthesia to put him or her to sleep throughout the treatment.
  • Your child’s vital indicators, including heart rate and blood pressure, will be closely monitored during the procedure.
  • Your surgeon will make an incision through the skin and muscle of your child’s ankle after cleansing the afflicted region.
  • Your surgeon will make a little incision if your procedure is minimally invasive. To execute your procedure, the surgeon will insert tiny instruments and a camera into the incision.
  • Your surgeon may remove the ATFL and CFL ankle ligaments from their attachment points on the fibula and shorten these straps.
  • The Surgeon will then reattach these ligaments to the fibula using new small holes drilled into the bone.
  • If necessary, the surgeon can perform other repairs.
  • The skin and muscle layers around the ankle are surgically closed.

After Ankle Laxity Surgery

After your child’s procedure, someone will keep watch over your child for a while. Most likely, the surgeon will have immobilized your child’s ankle. Reconstruction of the lateral ankle ligament can occur as an outpatient operation. You and your child can thus return home that day. After the operation, your child will have some pain for a while, especially in the initial days. There will be pain after the procedure and painkillers can reduce or eliminate the pain. Pay close attention to all directions on medication use and wound care. Keeping your child’s leg elevated may also help to lessen discomfort and swelling. For least a few weeks, the child will probably need to wear crutches and avoid putting any weight on the injured ankle.

Tell your surgeon if your child gets a high temperature, chills, or worsening ankle discomfort. After the operation, you will need to come back in around 10 days to have the sutures or staples removed. At this point, your surgeon may also change the splint for a boot or cast. Your doctor will probably switch out this cast with a detachable brace in a few weeks. The patient must use the brace for several months.

As your child recuperates, your doctor will offer you detailed advice on how to strengthen your child’s ankle and leg muscles. Physical therapy could be advantageous as well. This will increase the likelihood that the procedure will go well. The likelihood of experiencing issues depends on the age, foot anatomy, and general health. Patients with questions, concerns, or worries should discuss them with their doctor.

Conclusion of Ankle Laxity

Medical City Children’s Orthopedics and Spine Specialists surgeons are rated and board-certified professionals in foot and ankle treatment. In addition, they have studied and trained in the treatment of foot and ankle conditions in children and adolescents.

Finally, the orthopedic doctors at Medical City Children’s Orthopedics and Spine Specialists with offices in Dallas, Arlington, Flower Mound, Frisco, and McKinney, TX treat children with basic to complicated foot and ankle disorders, including persistent ankle instability. Using the latest in surgery techniques, our surgeons treat Ankle Laxity and persistent ankle instability patients on a routine basis with outcomes that allow the kids to enjoy being kids again.

____________________

Footnote:

American Academy of Orthopaedic Surgeons: Chronic Ankle Laxity

 

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at five convenient locations: Arlington, Dallas, Flower Mound, Frisco and McKinney.