What is it?
Ankle sprains are one of the most common sports-related injuries, affecting nearly 10,000 people per day. When the ligaments on the outside of the ankle are stretched or torn, patients can have pain and feelings of instability. If symptoms persist after non-surgical treatment, surgery may be required. The goal of this surgery is to restore normal stability to the ankle. This should also fix the feeling that the ankle “gives way” and any pain that is associated with an unstable ankle.
Sprains often exhibit with tenderness over the affected area,
discomfort during weight bearing, and bruising or swelling in the foot or ankle. Most sprains heal well with conservative treatment such as exercising the ankle, over the counter anti-inflammatory medications, and wearing supportive shoes. If there is pain or weakness in the ankle after several weeks, it might be time for a check up so that your orthopedic surgery can get x-rays and examine the ankle to see if surgery may be warranted.
How are ankle sprains treated initially?
Your physician will typically recommend physical therapy and ankle bracing for up to 6 months before considering surgery. See our previous blog for more specific exercises and non-operative treatment for ankle sprains: physicaltherapyforasprainedankle
What surgery is required?
Ankle ligament reconstruction (ALR) typically is an outpatient surgery, which means the patient can go home the same day as the procedure. It is most often done under general or regional anesthesia. Other surgeries may be performed at the same time, most often arthroscopic surgery of the ankle joint. At least one larger incision is required for the ligament reconstruction.
Several different techniques can be performed depending on the individual patient. One option is to repair the patient’s own existing ligaments with stitches with a Bröstrom procedure. This procedure can result in a stronger repair because of support from other tissues. Another option is to use a tendon to replace the torn ligaments. This technique is similar to what is done in knee ligament reconstructions.
What is the recovery from surgery like?
You can likely expect to be in a splint or cast for a minimum of two weeks. It may be up to six weeks before weight can be placed on the ankle, and then weight bearing is gradually advanced in a removable walking boot, and then they may transition to an athletic ankle brace.
Ankle strengthening begins after six weeks as pain and swelling allow. This may involve formal physical therapy or a consistent home exercise program. Running and sport-specific exercises can then start gradually. The total expected recovery time is 6-12 months. It is recommended that patients wear a brace for sports activities for up to a year.