How Do I Choose the Best Treatment for a Swollen Ankle?

Ankle sprain is a common clinical disease, and it has the highest incidence among joint and ligament injuries. The ankle joint is the body's closest weight-bearing joint, which means that the ankle joint is the joint with the most weight on the body. The stability of the ankle joint plays an important role in the daily activities and the normal performance of sports. Ligament injuries around the ankle joints belong to the category of ankle sprains. Ankle sprain injuries may include anterior talofibular ligament and fibula ligament of the lateral malleolus, triangular ligament of the medial malleolus, and transverse tibiofibular ligament.

Basic Information

English name

sprain of ankle joint

Visiting department

orthopedics

Multiple groups

Like sportsman

Common locations

ankle joint

Common causes

Caused by improper walking, external force, loose ligaments

Common symptoms

Pain and swelling in the sprained area immediately after injury, followed by skin bruising

Causes of ankle sprains

Ankle sprains are the most common sports injuries, accounting for about 40% of all sports injuries. The ankle joint consists of the distal tibia and fibula and the talus. The ankle points are formed by the medial and lateral ankles and the posterior edge of the tibia. The saddle-shaped articular surface above the talus is located in the ankle points. The talus saddle joint is wide in front and narrow in the back, and enters the ankle point at the wide part when the dorsiflexion is extended, and enters the ankle point at the narrow part when the plantar flexion, so the ankle joint is slightly loose in the plantar flexion position. Its anatomic and physiological characteristics determine the A varus sprain is more likely to occur when flexing. Because the ankle joint has a longer lateral ankle and fibula, the ankle is deeper, and the medial malleolus is shorter than the short ankle, so the ankle is more prone to varus sprains. Injuries of the lateral malleolus, including the anterior fibula ligament and the calcaneal fibula, are more common. Although ankle valgus sprain is not easy to occur, it is very serious once it occurs. If an rupture occurs, it usually causes ankle instability, and it is often accompanied by other ligament injuries and fractures.

Clinical manifestations of ankle sprain

The clinical manifestations of an ankle sprain include pain and swelling in the sprained area immediately after the injury, followed by skin bruising. In severe cases, the feet cannot move because of pain and swelling. With a lateral ankle sprain, the patient's pain worsened as he attempted to perform a varus. When the medial triangular ligament is injured, the patient becomes more painful when trying to perform a foot valgus. After the break, the pain and swelling may disappear, and the ankle joint may be unstable due to loose ligaments and repeated sprains.

Diagnosis of ankle sprain

Medical history

The patient has an acute or chronic ankle sprain, a first sprain or a repeated sprain.

2. Symptoms and signs

Symptoms in patients with first sprains are often severe, with pain and swelling in the ankle joints, ankle dislocation sensation during sprains, mild ankle inversion, and obvious tenderness points at the lateral ligament shape of the ankle joint. Acute injury is difficult to complete due to pain and swelling of the wound. After anesthesia and analgesia, positive drawer test and positive varus stress test may be detected. The examination should be compared with the normal joint on the contralateral side to prevent misjudgment due to congenital joint relaxation. Patients with chronic injuries or repeated sprains are relatively mild, and drawer tests and varus stress tests are more likely to elicit positive signs.

3. Imaging examination

First, an ankle and lateral X-ray should be taken to rule out whether there is an ankle fracture. An MRI examination can then be performed to determine the condition of the ligament damage and to know the damage of the joint capsule and articular cartilage.

The location and severity of ankle sprain were determined based on physical signs and imaging examination.

Ankle Sprain Treatment

After an ankle sprain occurs, you should go to the emergency department of the hospital immediately. Before the consultation, you can handle it according to the RICE principle. The RICE principle includes rest. Affected limb. After the visit, the doctor evaluates the injury and decides the treatment plan.

Generally, the milder lateral malleolus ligament injury can be treated conservatively. The conservative treatment scheme is generally to fix the ankle joint in a mild valgus neutral position with plaster or braces. The fixed time is 3 to 6 weeks. Try to avoid loading during the fixed period. Remedial training should be performed immediately after removing the cast or brace to prevent muscle atrophy and possible joint adhesions. Remove plaster to walk with a load. After three months of rehabilitation, muscle strength and physical activity can be restored.

For more severe lateral malleolus ligament injury, patients with ankle instability and articular capsule tears are recommended to repair the ligament to prevent repeated sprains caused by ankle instability. Postoperative plaster fixation is required for 3 to 6 weeks, and walking can be carried after weight removal. Generally, physical activity can be resumed three months to six months after surgery.

Simple medial malleolus ligament injuries rarely occur. Patients with a history of valgus sprains with pain and swelling at the medial malleolus should be highly suspected of having other injuries. For simple medial malleolus ligament injury, casts or braces can be used for mild varus and neutral fixation for 3-6 weeks. Rehabilitation training immediately after removing the plaster prevents muscle atrophy and joint adhesion. Physical activity can resume in about three months. Severe medial malleolus ligament injury is usually accompanied by fractures or other ligament injuries, and this situation requires surgical treatment.

Ankle sprain prevention

Ankle sprains are usually accidental injuries. There is no effective way to prevent ankle sprains. Strengthening the muscle strength around the ankle joint, wearing appropriate protective gear when performing high-risk sports, and being proficient in the technical actions of the activities performed can partially prevent the ankle sprain or reduce the severity of the ankle sprain.