Introduction
Staying physically active through regular exercise and sports have many health-related benefits. But sometimes, while performing these activities, an injury to the muscles may cause temporary immobility or disability, such as a twisted wrist, sprains, etc. For example, a sprain in the ankle is a common injury among people. It occurs because of the overstretching or pulling of the ankle ligaments. Approximately 25 percent of all sports-related injuries are ankle ligament injuries, while lateral ankle sprain is more common among dancers and is found among 76 percent of professional dancers.
Generally, medications and home therapies such as ice packs are enough to treat the problem, and surgery is not required for all ankle problems. But if the ankle injury results in deformity, instability, functional disability (unable to walk or move), and pain, then surgery is the best option.
What Is an Ankle Ligament?
A ligament is a tissue that connects two bones. For example, ankle ligaments are the band of tissues that connect the foot bone (talus, calcaneus) with the lower leg bone (tibia, fibula).
What Is the Function of the Ankle Ligament?
Ankle ligaments stabilize the ankle joint; prevent the ankle from collapsing or twisting. In addition, ligaments hold the foot and ankle together.
How Many Ligaments Are There in the Ankle?
There are three main ligaments in the ankle:
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Medial Ligaments (Deltoid Ligaments) - Form the bump on the inner side of the ankle. These start at the medial malleolus (bump outside of the ankle) and end of the tibia.
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Lateral Ligaments - Start at the lateral malleolus (end of the fibula).
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Syndesmotic Ligaments - These connect the tibia and fibula.
What Is Ankle Ligament Surgery?
It is a repairing procedure to surgically treat a serious sprain, overstretching or tearing of ligaments, or instability in the ankle. The injury can occur in any of the three ligaments mentioned above. Therefore, it is also known as the Brostrom procedure, ankle ligament tear surgery, ankle ligament tightening surgery, or ankle repair ligament surgery.
What Is the Most Commonly Injured Ligament in the Ankle Ligament Injury?
The lateral ligaments are the most commonly injured.
What Are the Symptoms of Ankle Ligament Injury?
An injury to the ankle ligaments occurs as a result of a sprain. The symptoms depend on the severity of the sprain. A few common symptoms are the following:
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Swelling of the ankle.
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Pain.
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Bruising (discoloration of the skin).
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Bleeding in the surrounding tissues.
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Lack of stability in the ankle joint.
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Discomfort.
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Weak ankle support while walking.
How Is the Ankle Ligament Injury Diagnosed?
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Physical examination to check the movement and instability.
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Imaging tests such as an X-ray to see if the bone is fractured and confirm the diagnosis, and magnetic resonance imaging (MRI) scan to evaluate the surrounding structures.
What Is the Procedure of Ankle Ligament Surgery?
Surgery is performed by the doctor occasionally when the ankle ligament, more commonly lateral ligament, is torn, stretched, or injured severely. In most cases, firstly, non-surgical treatment is given to treat the injury for at least six months. When the instability does not go away, and healing of the injury takes more than expected, surgery is done to tighten the injured ligaments of the ankle. In this procedure,
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Anesthesia is given, probably general anesthesia.
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Vital signs, such as heart rate and blood pressure, are monitored carefully.
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The affected area is cleaned with an antiseptic and cotton gauze piece.
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A cut or incision is made on the ankle through the skin and muscle.
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The torn ligaments, such as lateral ligaments, may be removed from their attachment site, generally from the fibula.
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The ligaments are made shorter depending on the severity of the injury.
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The ligaments are reattached to the fibula by drilling new holes in the bone.
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The surgical site is then closed through suturing (stitches).
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Painkillers are given to relieve the pain, and plaster may be placed temporarily.
What Are the Types of Ankle Ligament Surgery?
There are many different procedures; more common procedures are listed below:
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Lateral ligament repair or reconstruction.
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Ligament tightening.
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Tendon graft procedure.
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Peroneus Brevis tendon rerouting.
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Peroneus Brevis tendon loop.
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Peroneus Brevis tendon splitting and rerouting.
What Does Ankle Ligament Surgery Treat?
The ankle ligament surgery is done to:
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Treat severe sprains.
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To remove the instability in the ankle.
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To regain mobility and functionality.
When Is Ankle Ligament Surgery Needed?
The surgery is needed if any of these conditions are present:
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One or more ligaments are stretched or loosened.
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Repeated or recurrent ankle sprains.
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Chronic or long-standing pain.
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Failed non-surgical treatment.
What Are the Benefits of Ankle Ligament Surgery?
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The patient can walk normally after 12 weeks.
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The patient can resume high sports activities.
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Improved stability and support of the ankle joint.
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The patient can perform daily life activities.
What Are the Risks and Complications of Ankle Ligament Surgery?
The risks may be related to the surgical procedure; a few common risks and complications are mentioned below:
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Swollen ankle after surgery that may take a few months to go away.
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The surgery may fail (although there is a lesser chance of failing) and may require another surgery.
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The surrounding nerves may get injured, leading to numbness.
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Formation of a blood clot at the surgery site.
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Chronic regional pain syndrome - The patient may develop pain, swelling, and sensitivity after surgery. This condition may require seeing a specialist or pain consultant.
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Infection at the surgery site may develop.
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Recurrent ankle instability or stiffness.
What Is the Success Rate of Ankle Ligament Surgery?
The surgery is successful in 90 to 95 percent of patients.
What Is the Recovery Time for Ankle Ligament Surgery?
The recovery takes three to four months, after which the patient can walk normally.
How Much Does Ankle Ligament Surgery Cost?
Any surgical procedure is expensive, and the cost may vary on the type and severity of the injury, hospital stay, and other factors.
Conclusion
An ankle ligament injury may not always require surgical treatment. Most injuries can be treated through medications and available treatment options such as physical therapy. Regardless of the treatment option, regaining stability and movement should be the focus. Of all the surgical techniques, ligament repair and reconstruction are commonly applied procedures that provide fast recovery, and the patient can walk normally after three to four months.
