Treatment of Ankle Instability
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Ankle instability is the main cause of ankle dislocations and subluxations, which eventually lead to a tear or detachment of the ligament. Most patients develop it due to instability of the mechanical ankle. It is caused by an improper movement of the talus in the joint. The patient requires stress X-ray to diagnose it, since simple palpation or X-ray cannot determine the signs for a correct diagnosis. Therefore, patients who are often diagnosed with a wide range of diseases, the treatment of which comes down to simple physiotherapeutic procedures, such as massage, applications and baths.
The most common complaints of the patients with ankle instability include:
- Uncomfortable walking
- Frequent ankle twisting
- Anticipation of foot dislocation
- Nagging pain and swelling
Patients with ankle instability are usually recommended to have surgical treatment, which aims to restore the anterior astragalofibular and calcaneofibular ligaments. The following tests will be necessary:
- X-ray
- Ultrasound
- MRI
- CT
- The anatomic Brostrom procedure is used to treat ankle instability abroad. It can fully preserve joint elasticity and its amplitude of movement. It is very important for professional athletes and dancers. The procedure contributes to their complete rehabilitation for the further physical activities. This technique is less traumatic and preserves 100% proprioception. In addition, the patients’ gait does not change. This technique can be prescribed for a fresh injury without a long medical history. A traumatic injury of the anterior astragalofibular and calcaneofibular ligaments is treated by a special bending fixator that is placed over the ligaments. In this case the patient does not need any fixation by other types of ligaments. The patient eventually gets a plaster boot or an orthosis for around 1,5 months and after their removal the specialists provide rehabilitation for restoring joint mobility.
- Nonanatomic treatment is recommended in all other cases with a long medical history, when it is impossible to provide anatomic therapy. This technique offers its own advantages and high stability. In this case ankle arthroscopy is the most effective.
Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko