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Ankle Instability

                                                                                                                         Mr Tim Clough

Who does it affect?

Usually follows an injury or repetitive injuries to the ankle. Ligaments on the outside of the ankle may be ruptured or stretched. 

Symptoms

Recurrent instability (going over) on the ankle.  In a few cases further damage may occur within the ankle causing pain. In the long term repetitive episodes of instability can lead to early arthritis within the ankle. 

Investigations

An X-ray will indicate whether there is any further damage within the ankle or any evidence of early arthritis. MRI scan may be required to confirm the full extent of the ligamentous damage at the ankle. 

Non-operative treatment

Initially rest, ice, compression and elevation. Later physiotherapy with strengthening exercises.  Occasionally supervised strapping or use of a brace may be required. 

Operative treatment

If your surgeon feels there is damage within the ankle then initially an arthroscopy of the ankle would be required. If however, there is no damage to the ankle then should non-operative treatment as outlined above fails, then surgery to reconstruct the ligaments and stabilise the ankle would be required. 

Surgery is performed under a general anaesthetic or spinal anaesthesia. A tourniquet is used, which is like a blood pressure cuff around the upper thigh to prevent blood from obscuring the surgeonís view. In some cases the torn ligament can be repaired, but in other cases it cannot, and an adjacent tendon has to be used to reconstruct the torn ligament. The skin is sutured and an immobilising plaster of paris slab is applied. Patients are allowed to weight bear immediately with the protection of crutches.