ANKLE LIGAMENT RUPTURE

QUESTIONS AND ANSWERS

Who Is Ankle Ligament Reconstruction Intended For?

Ankle ligament reconstruction is primarily designed for individuals who lead an active lifestyle and are in good health. It’s especially beneficial for those who have suffered multiple ankle sprains, which can result in lasting ankle instability and discomfort.Such frequent sprains can weaken the ligaments on the lateral side of the ankle, making reconstruction necessary to restore stability and alleviate chronic pain. This surgical option is best suited for those seeking to return to their active routines without the setbacks of persistent ankle issues.

If you find that ankle instability is interfering with your daily life or athletic pursuits, this procedure could be the solution you’re looking for. Always consult a medical professional to determine if you are an appropriate candidate.

How Effective is Ankle Ligament Reconstruction in Resuming Activity?

Ankle ligament reconstruction is highly effective for individuals struggling with ankle instability, significantly enhancing their ability to engage in activities that were once limited. This surgical procedure aims to restore stability and strength to the ankle, addressing the underlying issues responsible for recurring sprains and discomfort.

Clinical Success: Studies have shown that most patients experience a marked improvement in ankle stability and function following the surgery. This allows them to return to their normal activities, ranging from day-to-day tasks to more demanding sports-related endeavors.

Recovery and Outcomes: The majority of patients can resume light activities within a few weeks post-surgery, with gradual progression to more intense activities over a few months. Long-term outcomes are also positive, with a reduced risk of re-injury and improved overall ankle health.

Patient Testimonials: Many patients report an enhanced quality of life post-procedure as they gain confidence in their ability to perform activities without fear of instability or injury.

In essence, ankle ligament reconstruction stands as a reliable solution for reclaiming mobility and strength, empowering individuals to confidently resume their active lifestyles.

Causes Of Ankle Ligament Rupture

When the ankle moves out of its normal position with a sudden force, a sprain occurs. One or more of the ankle’s ligaments get stretched, partially torn, or torn completely.

The causes of ankle ligament rupture include:

• A sudden accident or fall can twist an ankle.
• When a child lands awkwardly on one foot after running, jumping, or pivoting.
• Falling on the heels of the feet.
• Walking or exercising on an uneven surface.
• When another person steps or lands on your child’s foot during a sports activity.

When To Seek Medical Advice?

After the injury has occurred, check whether your child can put weight on his or her foot for 20 minutes. If not, it’s necessary to see a doctor. The doctor will take an x-ray to check for any broken bones in the ankle; however, it will not show any sign of soft tissue damage. For less severe injuries, you can treat the sprains at home as well. But it is better not to leave the ankle sprain untreated for a very long time.

The supportive structures around the ankle get stretched, causing micro-tears or the tearing of the bone altogether. However, proper treatment can prevent long-term instability and the chances of other issues like arthritis. When you seek medical treatment for ankle ligament rupture, it helps us to understand how the ankle injury occurred.

How Are Ankle Ligament Ruptures Diagnosed In A Child?

Ankle Ligament Rupture is diagnosed depending upon the physical findings and functional loss from grade I – grade III:

A grade I sprain: The child or young adult at this stage may experience mild swelling and instability. In most cases, there is no sign of joint instability, and the patient can move with minimal pain. Generally, these injuries recover without medical intervention.

A grade II sprain: This is the more severe injury that involves an incomplete tear of the ligament. In this situation, the child may experience moderate pain, tenderness, bruising, and swelling. They might face some restrictions in motion and loss of function. Above all, carrying the body weight and movement can get painful.

A grade III sprain: At this stage, after an X-ray, you will find a complete tear of a ligament. Here, the pain gets unbearable with severe swelling, pain, bruising, and tenderness. If the doctors find any significant mechanical instability on the exam, they might require surgery.

In cases where the lateral ligaments are severely damaged, the medical team may opt for a procedure involving an allograft. This involves using a cadaver tendon to reinforce the compromised ligaments, aiding in restoring stability to the affected area. This specialized approach is crucial when the body’s natural healing is insufficient, providing a robust solution to facilitate a full recovery.

Treatment Of Ankle Ligament Rupture

The treatment of Ankle Ligament Rupture begins with a thorough diagnosis. Generally, it includes a physical examination that tests stability, motion, and ability to bear weight and reviews the history of the injury. For severe cases and to detect the problem more accurately, the health care professionals may suggest an MRI or an ultrasound scan. Initially, an X-ray is necessary to check for a fracture.

Non-surgical

Physiotherapy can treat partial ankle ligament tears. To help build up the muscles around an ankle, your child will need to conduct some exercises. It improves stability and prevents re-injury. A full tear, though, will need immobilization for three weeks. The doctors recommend a targeted massage to stimulate blood flow. It boosts the healing process and reduces the build-ups and the thickening caused by scar tissue.

For those with mild or moderate ankle instability, non-operative treatments often suffice in resuming activities without the need for surgery. Supportive ankle braces are another key component. They provide the necessary support to prevent further injury and aid in stabilizing the ankle during movement. However, if these conservative approaches do not alleviate symptoms, surgery may become an option to consider. It’s essential to assess the effectiveness of non-surgical methods before proceeding to surgical interventions. This ensures that all avenues for recovery have been thoroughly explored.

The injection therapy reduces inflammation after the ligament tear.

Understanding Ankle Ligament Reconstruction

Ankle ligament reconstruction is a surgical procedure aimed at repairing stretched or torn ligaments on the lateral side of the ankle. The primary ligaments involved are the anterior talofibular ligament and the calcaneofibular ligament, both critical in stabilizing the ankle.

This procedure caters to individuals who frequently experience ankle sprains that lead to persistent instability and discomfort. While non-surgical treatments like physical therapy and the use of ankle braces may suffice for those with mild to moderate issues, surgery becomes a viable option when these methods fail to restore ankle stability.

What Preparations Are Needed Before Ankle Ligament Reconstruction Surgery?

Before you undergo ankle ligament reconstruction, there are essential steps to ensure a smooth surgical experience and recovery.

Know Your Surgical Center

First, familiarize yourself with the location of your outpatient surgery center. Understanding where to go will help reduce stress on the day of your procedure.

Medical Evaluations

Patients over 50 or those with specific health conditions need further evaluation. Be prepared for a blood work-up and an EKG to assess your readiness for surgery.

Medication Adjustments

Adjusting your medication regimen is critical. Discontinue blood thinners well in advance of your surgery to reduce the risk of excessive bleeding. This includes:

• Prescription Blood Thinners: Such as warfarin or clopidogrel.
• Over-the-Counter Pain Relievers: These include aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen.
• Supplements and Herbs: Avoid those known for causing blood thinning.

Consult Your Primary Care Doctor

If you are taking prescribed medications like warfarin or clopidogrel, consult your primary healthcare provider before making any changes. They will guide you on how to safely manage your medication before your surgery.

By following these preparatory steps, you’ll be well on your way to a successful ankle ligament reconstruction and recovery.

The Surgical Process

A healthcare professional suggests surgery if the ligament rupture has damaged the other structures of your ankle. Surgery is also recommended during long-term instability or other conditions like arthritis. Through surgery, surgeons can repair damaged ligaments by stitching them back together and re-attaching them to the bone or replacing them with a graft. Moreover, surgeons conduct ankle ligament rupture surgery by using keyhole (arthroscopic) surgery. 

During the surgery, doctors evaluate the condition of the ligaments. If they are suitable for repair, they are tightened by detaching and reattaching them in a more stable position. In cases where the ligaments are too damaged, a tendon from a donor (allograft) might be utilized to reinforce the weakened areas.

The decision to reconstruct one or both ligaments depends on the severity of the instability. The effectiveness of this procedure is significant, allowing patients to regain their previous level of physical activity without the limitations imposed by ankle instability.

When Can Patients Start Weight-Bearing After Surgery?

After surgery, patients often wonder when they can start putting weight on their leg. Generally, weight-bearing can commence once a CAM walker boot is fitted. Patients can progress from partial to full weight-bearing as they become more comfortable.

Step-by-Step Guidance:

• Initial Phase: Start by putting approximately 50% of your body weight on the leg. This step should be taken at a patient’s own pace and comfort level.
• Progression: Gradually increase to full weight-bearing. This means you can walk without the aid of crutches. Typically, this transition should occur over a few days.

Always follow your healthcare provider’s specific advice regarding your weight-bearing status, as individual recovery may vary.

Care At Home

If your child has a sprained ankle and if the pain is not serious, parents can take care of it at home as well. Use the first aid principles or the RICE strategy – Rest, Ice, Compression, Elevation, and ankle Exercises. Without a doubt, it’s necessary to start the treatment and continue it for three to four days.

•  Rest – Give rest to the injured area and avoid pain-causing activities. If it’s difficult to walk, use crutches.
•  Ice – For 10-15 minutes, apply ice to the injured area. At this time, never place the ice directly on the skin. Ice the injury for two to three days, every two to four hours. Make your DIY ice pack using a plastic bag with water and some ice in it. This molds better to the joints than ice alone.
•  Compression – Fasten a firm bandage that is not too tight and does not prevent circulation or cause extra pain. Leave the toes and do not cover the ankle right down to the foot.
•  Elevation – It’s important to reduce the swelling by raising the ankle whenever possible.

How to Reduce Swelling and Pain After Surgery

In the first 72 hours following your surgery, prioritizing your recovery is key. Here are some steps you should consider:

• Elevate Your Leg: Position your leg higher than your heart. This positioning assists in minimizing swelling and alleviating pain effectively.
• Rest and Recover: Allow your body to heal by taking it easy. Avoid unnecessary movement and strain on the affected area.
• Cold Compress: Apply an ice pack to the surgical area for 20-minute intervals. This helps in numbing pain and reducing inflammation.
• Stay Hydrated: Drink plenty of fluids to keep your body well-hydrated, aiding in the healing process.
• Follow Medical Guidance: Adhere strictly to the advice provided by your healthcare professional, including any prescribed medications.

By following these recommendations, you can help ensure a more comfortable and speedy recovery.

Risk factors

Factors that increase the chances of ankle ligament rupture and the risk of a sprained ankle include:

• Sports participation

Ankle ligament tear is very common during sports injuries. It is more in particular sports like cutting action, jumping, rolling, or twisting of the foot like tennis, football, basketball, soccer, and trail running.

• Uneven surfaces

The risk of an ankle sprain increases during walking or running on a poor field or an uneven surface.

• Prior ankle injury

If your child has experienced sprained ankles before, they are likely to sprain them again.

• Poor physical condition

Less flexibility or poor strength in the ankles increases the risk of spraining muscles.

• Improper fitting shoes

If shoes don’t fit your child properly or are not appropriate for an activity, the ankles are more vulnerable to injury.

Complications

When you fail to treat the sprained ankle properly, it will take longer to heal and could lead to the following complications:

• Arthritis in the ankle joint
• Chronic ankle pain
• Chronic ankle joint instability

When to Immediately Contact Your Surgeon After Surgery

After a surgical procedure, it’s crucial to monitor your recovery closely. Here are several signs that indicate you should contact your doctor right away:

• High Fever: If your temperature exceeds 101°F, reach out to your healthcare provider.
• Intense Pain: Experiencing severe pain in your calf or any other specific area is a red flag.
• Wound Concerns: Be vigilant for any discharge or foul-smelling drainage from your surgical wound.
• Swelling and Redness: A noticeable and sudden increase in warmth or redness around the surgical site requires prompt attention.

Additionally, seek immediate emergency care if you encounter any of the following symptoms:

• Chest Pain
• Excessive Sweating
• Difficulty Breathing
• Rapid Heartbeat

It’s essential to be proactive during your recovery to ensure proper healing and address any complications promptly.

Prevention

The following tips will help parents prevent ankle ligament ruptures in their children:

• Warm up before any physical activity.
• Walk or run carefully on an uneven surface.
• Wear fitting shoes.
• Exercise daily to maintain good muscle strength and flexibility.

The Expertise at Medical City Children

Finally, if your child has a sprained ligament rupture or severe muscle sprain, you should see one of our doctors at Medical City Children’s Orthopedics and Spine Specialists as soon as possible.

Parents should consider bringing their child to Medical City Children’s Orthopedics and Spine Specialists for ankle injuries for several compelling reasons:

• Specialized Pediatric Expertise: Medical City Children’s Orthopedics and Spine Specialists exclusively focus on infants, children, and adolescents, providing specialized care tailored to the unique needs of young patients. Their experience and training in pediatric orthopedics ensure that children receive the most appropriate and effective treatments for their specific ankle injuries.
• Comprehensive Care: The medical center offers comprehensive care for a wide range of pediatric orthopedic conditions, including ankle injuries. From initial evaluation and diagnosis to advanced treatments and rehabilitation, parents can expect a holistic approach to their child’s care, all within one specialized facility.
• State-of-the-Art Technology: The medical center utilizes the latest advancements in pediatric orthopedics, including imaging and diagnostic tools, to accurately assess and diagnose ankle injuries. This cutting-edge technology ensures that the child receives the most precise and efficient care.
• Multi-Disciplinary Team: Medical City Children’s Orthopedics and Spine Specialists work collaboratively with other pediatric specialists, such as pediatric neurologists, physical therapists, and sports medicine experts, to provide well-rounded care for the child’s overall health and well-being.
• Minimally Invasive Techniques: The medical center emphasizes minimally invasive approaches whenever possible, which can lead to quicker recovery times, reduced pain, and improved outcomes for children with ankle injuries.
• Personalized Treatment Plans: Each child’s ankle injury is unique, and Medical City Children’s Orthopedics and Spine Specialists develop individualized treatment plans to address specific needs, taking into account the child’s age, growth, and activity level.

Conclusion

By choosing Medical City Children’s Orthopedics and Spine Specialists, with offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX, for their child’s ankle injury, parents can rest assured that their little one will receive expert care from a team dedicated to ensuring the best possible outcomes and a swift return to an active and healthy life.

____________________

Footnote:

London Foot and Ankle Surgery: Ankle Ligament Repair Surgery