![]() The deltoid ligament is a broad fan shaped ligament that lies on the medial (inner) side of the ankle. A CT scan helps confirm the diagnosis and management may require screw fixation for optimal outcome. This diagnosis is easily missed and requires a high index of suspicion. It is positioned on the inside of the foot, and tendons to the toes run above and below this section of bone. The ‘Sustentaculum Tali’ is a prominence of bone that is part of the calcaneus (Heel bone). Pain on the inner side of the ankle (Medial ankle pain)ĭepending on the mechanism of injury, ongoing pain on the inside of the ankle joint may represent a missed bony injury (sustentaculum tali fracture), deltoid ligament rupture, or an injury to the talus articular cartilage on the inner (medial) side. This typically represents ‘posterior ankle impingement’ that can occur due to the abutment of soft tissue or excessive bone (Os Trigonum). This is a less common region to experience ongoing pain. Pain at the back of the ankle (Posterior ankle pain) ![]() Depending on the severity of the injury, surgery to stabilise this ‘joint’ may be required. Syndesmotic injuries can also occur in the setting of an ankle fracture, which require an operation.Īn early diagnosis of a syndesmosis injury is important, as the management differs from a ‘simple’ ankle sprain. ![]() The pain is often located just above the level of the ankle joint, and is made worse with external rotation of the foot. This injury often occurs when the foot is planted on the ground, and an excessive outward twisting of the foot occurs. Syndesmotic injuries are often referred to as a ‘High ankle sprain’ as the torn ligaments of the syndesmosis, lie above the more commonly injured lateral ankle ligaments. The ankle syndesmosis is a ‘fibrous joint’ between the lower end of the tibia (shin bone) and fibula. The majority of these conditions respond well to a keyhole arthroscopic ‘decompressions’. Soft tissue scarring and impingement can cause ongoing pain following ankle sprain. Impingement occurs due to compression of bony or soft tissue structures during these activities. Patients typically have difficulty with walking upstairs, landing from a jump, and pushing the brake in the car. Soft tissue or Bony impingementĪnterior ankle impingement is characterised by pain at the front of the ankle joint during activities that result in ‘dorsiflexion’ of the ankle. The loose bodies may move around inside the joint causing intermittent ‘locking’ of ankle movement.įollowing evaluation with an x-ray and MRI scan, keyhole ankle arthroscopy is performed to remove these ‘loose bodies’ and evaluate the cartilage surface of the ankle joint. Patient will typically have ongoing pain and the sensation of something ‘catching’ inside the ankle joint. These ‘bodies’ can increase in size once detached. A keyhole ankle arthroscopy is frequently required, and then the cartilage damage needs to be addressed.ĭuring a high energy ankle sprain, cartilage impaction can result in the formation of loose bodies that become entrapped within the ankle joint. X-rays and advanced imaging (MRI scan) will confirm the severity of the cartilage damage, and a tailored management plan is discussed. Patients experience difficulty walking on uneven ground. ‘Catching and clicking’ of the joint is often experienced. Patients will present with ongoing pain at the front and outer aspects of the ankle joint, with associated swelling. Impaction occurs between the talus and the lower end of the fibula, resulting in loss of cartilage in this area. The ‘Talus’ is a large bone of the ankle that articulates with the lower end of the tibia (shin bone) and fibula.Ĭartilage damage can occur in the anterolateral (front/outside) part of the talus, following a twisting injury. Talus OCD (cartilage damage)Īrticular cartilage damage may include displacement of a section of the joint surface of the ankle. Pain in this region is likely due to either joint surface (chondral/articular surface) damage or associated ‘impingement’ from soft tissue scarring. This is a common area to experience ongoing pain following ankle sprain. Pain at the front of the ankle (Anterior ankle pain) Depending on the location of the pain, various pathologies need to be considered. Pain following ankle sprain is often associated with ongoing swelling and a loss of confidence in the stability of the ankle. While the majority of ‘simple’ ankle sprains go onto a good recovery, there are a substantial subset of patients with more ‘complex’ injuries that have ongoing pain following ankle sprain.Īt the time of the injury, it is possible for damage to occur to the ankle joint itself, as well as the surrounding soft tissues and tendons.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |