Treatment of Ankle Sprain and Rupture in Germany

The ankle joint is one of the most physically loaded joints in the human body. It supports the entire body weight while walking and running. A feature of ankle injuries is that they are often detected untimely, after the formation of chronic joint instability. In more than half of the cases, doctors have to deal with chronic torn ligaments that require more complex surgical procedures.

Content

1. Which ligaments are torn due to the injury
2. Surgical treatment methods
3. Rehabilitation

Which ligaments are torn due to the injury

Ankle ligament tears account for up to 20% of sports injuries. The following ligaments are affected: 

• Deltoid ligament 
• External ligamentous complex, including the talofibular ligament
• Tibiofibular ligament 

There are partial and complete ligament tears. The most common are distal tibiofibular ligament ruptures.

Surgical treatment methods

Ankle ligament injury requires surgery to repair the ligament. Doctors use different options of surgical approaches: 

• Arthroscopic method – operation through short incisions, with thin long instruments, under the guidance of a mini video camera 
• Open surgical method – a conventional technique for performing the operation through a large incision in the leg 

In Germany, preference is given to arthroscopic interventions. They are safer and less traumatic. Rehabilitation after such surgical interventions is easier and faster.

Here is what the doctor can do when performing the surgical intervention: 

• Suture the torn ligament 
• Strengthen it with the fragments of the patient's tissues or synthetic materials 
• Create a new ligament with the use of autologous, donor, synthetic materials 

Whenever possible, anatomic ligament reconstruction is used. Non-anatomic reconstruction to stabilize the ankle can also be performed, but it provides worse functional outcomes, so it is rarely used in developed countries.

Ligament reconstruction material: 

Autoplasty is the restoration of tendons from other parts of the body. The tendons of the calf muscles are most often used. The advantage of this approach is that the recreated ligament is very strong. A person can tolerate any physical activity, and the risk of repeated injury remains low. This variant of plastic surgery is suitable for athletes who have high requirements for functional outcomes. 

Alloplasty is a donor tendon transplant. The advantage of this treatment method is that doctors do not need to inflict additional trauma in the area of ​​the donor site. The other tendon in the leg is not weakened. There is no risk of complications from the donor site. Doctors can choose any size of the tendon, individually for the patient. But there is a drawback: the preserved tendon is not as strong as the fresh one. Therefore, the risk of repeated rupture in the case of significant sports loads will be quite high. The operation is suitable mainly for elderly patients with a low level of physical activity.

Synthetic materials are ligament endoprosthesis made from various materials, and their quality is constantly being improved. Most artificial ligaments are not as strong as the patient's own. In recent years, new ligaments with increased strength have appeared. They provide results comparable to autoplasty. However, widespread use of these materials is limited by the high cost of endoprostheses.

Rehabilitation

Rehabilitation after arthroscopic surgery is easier and faster than after open surgery. But after any surgical intervention, the recovery time is long: it will take several months before the tendon fully heals and becomes strong enough for a person to return to sports and physical work.

Immediately after the operation, the ankle joint is immobilized. The patient undergoes physiotherapy procedures, receives pain medication, and has a massage. Whenever reachable, exercises begin as early as possible: they increase blood flow to the lower extremities and prevent muscle atrophy. In addition, the risk of developing thrombotic complications is reduced.

The period of immobilization of the limb is 1-2 months. It often takes place in two stages: rigid immobilization is replaced by an orthosis of medium or light fixation. It allows the patient to start exercising earlier to relieve muscle atrophy.

1.5-2 months after the operation, the most intensive stage of rehabilitation begins: a person works out on fitness equipment, builds muscles, restores the sensitivity of the ankle joint, and forms the correct walking stereotype. After 3-4 months, the intensity of training increases; the patient can restore sports skills, and after 6 months he reaches the strength and volume of the muscles of the lower limb, as before the injury and surgery.

To undergo ankle ligament injury diagnostics and ankle ligament injury treatment in Germany, you are welcome to use the Booking Health service. On our website, you can find out the cost of medical services. You can compare how much is the price for treatment in different German clinics in order to book a medical care program at favorable prices. The specialists of the Booking Health company will help you choose a clinic and organize your trip.

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Farrukh Ahmed. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

Sources:

Journal of Orthopaedic Trauma

Medscape

Mayo Clinic