Ankle Joint Injuries & Treatment
The ankle joint is the smaller joint as compared to the knee or hip joint but takes the same load of the whole body. Three bones form the ankle joint- the tibia-fibula and the talus. Like any other joint the bones that come in contact have a coating called as cartilage. These bones are held in place by various ligaments which envelope the ankle joint.
This is the most common problem affecting many patients. The injury can be very minor to a chronic condition causing major problems in day-to-day movement. Usually the injury is sustained while playing, running, jogging, getting down stairs, at home in bathroom and other slippery places
1. What are the indicators of serious injury?
Severe pain and swelling, inability to put weight on the leg or walk, bruising and symptoms lasting for more than 5 days
2. What happens in ankle sprain?
There can be ligament, tendon or/ and bone injury. Ligament injury can range from minor sprain to major complete tears. Bone can be fractured and tendon can be strained.
3. What is the treatment?
The treatment depends on the extent of injury. Minor sprains need rest, ice applications and splinting for 2-3 weeks. Major sprains and some fractures may require plaster cast application. In some cases of fractures and complete ligament tears surgery may be needed.
4. What is the recovery period?
Again this is very individual. It depends on the extent of injury. It can vary from 2 weeks to 3 months or more depending on the severity of the injury.
5. What investigations are required?
An X ray is the basic investigation. A CT scan or MRI may be required depending on the injury.
1. What is osteochrondritis dissecans?
In this condition the blood supply to a small part of the bone with the cartilage on top of it gets interrupted. This part of bone and cartilage becomes dead. In some patients the blood supply gets restored and the lesion heals. This is usually in adolescents and young patients. In older patients the dead bone and cartilage get separated and form loose body in the joint.
2. What are the symptoms?
There is pain and sometimes swelling in the ankle in the initial stages. There is pain in movements and tenderness at the spot of the lesion. There is progressive difficulty in walking, climbing stairs and sitting cross-legged.
Later when a loose body forms, the ankle joint may get locked in one position. Such locking episodes may occur once or multiple times. These episodes are painful. Other patients may feel clicking inside the joint occasionally.
If the lesion heals on its own
3. What are the investigations needed?
X-rays, MRI and if a loose body is seen then a CT scan may be required.
4. What is the treatment?
It depends on the stage of the disease. If there is a loose piece lying in the joint then the only option is arthroscopic surgery. There are two puncture holes around the ankle joint and the loose piece is extracted. If the defect left behind by the loose piece is small then only a small additional procedure is required. If the defect is large then there are other options that can be discussed with the doctor during consultation.
