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Ankle Instability

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Orthopaedics 360

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The majority of ankle sprains occur following a twisting injury. Typically this is an ‘inversion’ type injury where the ankle turns inwards and the body ‘goes over’ the ankle joint. This pattern results in injury to the outer (lateral) sided ankle ligaments (ATFL / CFL). 

There are varying degrees of severity of ankle sprains, depending upon whether the torn ligament/s is a partial or complete tear, and how many of the ligaments are involved.

 

Anatomy of the Ankle Ligaments

 

The ankle joint itself is made up of the two bones in the lower leg (tibia and fibula) and the talus (large bone that connects to both the tibia and fibula). The joint is stabilised by surrounding ligaments that provide stability. These ligaments are comprised primarily of lateral (outer) sided ligaments and medial (inner) sided ligaments.

 

The lateral (outer) ligament complex is formed by three distinct ligaments.

 

Anterior Talofibular Ligament

Calcinofibular Ligament

Posterior Talofibular Ligament 

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The Medial (inner) ligament complex is called the ‘Deltoid‘ ligament. The deltoid ligament is a broad ligament with attachment from the lower part of the tibia (medial malleolus) and spans out to several of the small bones of the foot.

Ankle Instability  – Making the Diagnosis

 

Do you experience any of these?

Often a detail history is all that is needed to make the diagnosis of an unstable ankle joint. A patient who has had one or several ‘twisting’ ankle sprains, and who has the ongoing sensation that her ankle is going to collapse on them, has functional ankle instability. A thorough examination is performed to not only assess the integrity of the ankle ligaments, but to also exclude any additional injuries to the surrounding cartilage and tendons.

physical examination for ankle instability mike smith
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A plain xray will assess for small bone fractures and any evidence of arthritis around the ankle joint. A MRI scan can give detailed information regarding the joint cartilage surface and the surrounding ligaments and tendons.

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Ankle Sprains

What are you injuring?

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Recurrent Ankle Sprains Can Cause Arthritis

Initial Management

Have you tried this?

The majority of ankle sprains (up to 80%) will heal well with conservative management. To achieve the best outcome, an active physiotherapy program should be commenced.

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Functional Rehabilitation

Early mobility +/- supportive orthosis

Gait Retraining

Proprioceptive Training

i.e Wobble board exercises to teach the ankle joint to stabilise itself

Range of Motion Exercises

Peroneal Muscle Strengthening

To reduce the risk of long term stiffness

 

Does your ankle keep giving way on you?

Recurrent ankle sprains can lead to long term cartilage damage and arthritis

Treatment is aimed at strengthening and stabilising your ankle joint

Want to get back to the sport you love?

Having difficulty playing sport due to your ‘weak’ ankle?

Ankle Ligament Stabilisation

Specialised sports reconstruction – Day Procedure

This technique is used to strengthen the outer (lateral) ligaments of your ankle joint. A keyhole arthroscopy is commonly performed at the same time to address any issues inside the ankle joint.

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Do you experience any of the following?

Frequent Ankle Sprains

Pain in your ankle

Swelling around your ankle

Ankle sprains and arthritis

People don’t generally tend to associate ankle sprains with ankle arthritis due to its seemingly innocuous presentation in comparison to ankle fractures or dislocations, however recurrent ankle sprains can result in serious trauma to the ankle. Post traumatic...

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Disclaimer: Please note that this is general advice only - for more information, please consult your regular doctor, or obtain a referral to see a specialist orthopaedic surgeon. 

Orthopaedics 360

Orthopaedics 360

P: (08) 7099 0188

F: (08) 7099 0171

Southern Specialist Centre

Orthopaedics 360

P: (08) 7099 0188

F: (08) 7099 0171

Health @ Hindmarsh

Orthopaedics 360

P: (08) 7099 0188

F: (08) 7099 0171

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