ankle sprains & instability
Ankle sprains are common injuries and range from minor damage to the ligaments supporting your ankle to complete tears and damage to the ankle joint itself. Depending on the exact nature of the damage, symptoms can merely be a nuisance for a few weeks but can cause long term problems.
You may well have attended an A&E or walk-in-centre when you had the injury and xrays may have already been performed and ruled out a fracture. It is likely that you may have had treatment for the sprain already via formal physiotherapy. In the vast majority of cases this will be all that is required to resolve the problem.
Some people experience continued discomfort, particularly in the front corner of their ankle. Occasionally this can be in combination with the ankle ‘giving-way’ when you feel the ankle will not support your weight at all times. This feeling of giving way or instability can either be due to an actual deficiency in the ligaments that stabilise the ankle or due to the fact that the ankle is generating pain and causes the muscles to weaken (functional instability).
An examination of the ankle in clinic can determine if the ligaments are grossly unstable. An MRI scan is usually necessary to determine any damage within the ankle joint itself.
If surgery is felt to be necessary it would usually be performed under a general anaesthetic. Your ankle is examined in theatre using an X-ray machine to fully determine if the ligaments are stable or not. A small telescope is then placed into the ankle joint (keyhole surgery) in order to assess any damage to the cartilage (slippy surface of the joint) and remove any scarring from within the joint.
If the ligaments have been determined not to be working then a ligament reconstruction will be carried out – this is performed through an incision on the side of the ankle and special stitches are inserted across the remnants of the injured tissue.
After ligament reconstruction you will be in a plaster cast for 2 weeks before being given a walking boot to use for a further 4 weeks. If the ligament reconstruction was not necessary then you will be able to bear weight from the day of surgery.