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Ankle Sprain and Rupture — Open Surgery: treatment in the Best Hospitals of Germany

St. Vinzenz Hospital for Orthopedics Duesseldorf

9.9/10
location_onGermany, Duesseldorf

Department of Adult and Pediatric Orthopedics, Foot Surgery

The Department of Adult and Pediatric Orthopedics, Foot Surgery offers the widest range of modern medical services to patients suffering from musculoskeletal diseases. The department specializes in knee and hip replacement surgery, including revision interventions to replace previously implanted artificial joints. The department has the status of a certified Maximum Care Endoprosthetics Center (endoCert), which means adherence to the requirements of European professional societies for carrying out procedures of this kind, a high level of safety and treatment efficiency. It is worth noting that the department uses the innovative ROSA® robotic system for performing knee replacement surgery. A special Rapid Recovery Program is used for the rapid recovery of mobility after joint surgery, which allows the patients to quickly return to their usual life. An integral part of the department's clinical practice is also the treatment of foot diseases and deformities in adults and children. The medical facility has been operating for more than 50 years, and therefore it provides patients with the highest quality medical care and easily copes even with highly severe pathologies.

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Vitos Orthopedic Clinic Kassel

9.2/10
location_onGermany, Kassel

Department of Adult and Pediatric General Orthopedics, Trauma Surgery

The Department of Adult and Pediatric General Orthopedics, Trauma Surgery offers the full range of diagnostics and treatment of musculoskeletal pathologies. The specialization covers joint replacement surgery, foot and hand surgery, shoulder surgery, treatment of rheumatic joint lesions, treatment of injuries, sports orthopedics, treatment of orthopedic problems in children and adolescents, as well as pain therapy. The key to successful clinical practice is the highest professionalism and unique experience of the department's medical team combined with the very latest infrastructure and advanced equipment.

University Hospital Ulm

9.2/10
location_onGermany, Ulm

Department of Adult and Pediatric Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics ranks among the top German departments specializing in joint replacement surgery! The department covers the full range of conservative and operative therapy in diseases of the musculoskeletal system, including the special pain therapy in the case of these pathologies, emergency treatment and long-term care for the patients with paraplegia. The department offers many sparing minimally invasive techniques, advanced navigation systems for high-precision interventions.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Adult and Pediatric Orthopedics, Special Orthopedic Surgery and Rheumatic Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics, Special Orthopedic Surgery and Rheumatic Orthopedics ranks among the top German medical facilities specializing in the treatment of orthopedic diseases in adults and children, as well as in hip surgery! The department offers the full range of medical services in these medical fields. It carries out both diagnostics and treatment of patients of all age groups, including very elderly patients, with various musculoskeletal diseases. The therapeutic options include both conservative and surgical treatment methods. The department is distinguished by high professionalism of doctors, advanced infrastructure and invaluable experience in the field of its specialization, due to which it occupies leading positions in the European medical arena and guarantees an optimal treatment result.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Adult and Pediatric Orthopedics, Traumatology

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics, Traumatology ranks among the top German departments specializing in endoprosthetic joint replacement! The department offers the full range of services in the field of diagnostics and treatment of all diseases of the musculoskeletal system. In addition to surgical treatment, a number of effective conservative treatments are available in the department, for example, physiotherapy, occupational therapy, therapeutic exercise. The highly qualified doctors who have a rich experience and outstanding treatment results take care of the patients' health. 

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Adult and Pediatric Orthopedics, Foot Surgery

The Department of Adult and Pediatric Orthopedics, Foot Surgery offers the full range of services for the diagnostics and treatment of musculoskeletal diseases: bone, joint, muscle, ligament and tendon diseases. Special attention in the department's clinical practice is paid to knee and hip replacement surgery, including revision interventions to replace previously implanted prostheses, treatment of foot diseases, musculoskeletal cancers, orthopedic diseases in children. In addition, the department's specialists deal with the treatment of rare and especially complex musculoskeletal diseases. The department's highly specialized medical team applies only modern diagnostic and therapeutic techniques in their practice, and the long-term experience of doctors guarantees top-class surgical and conservative treatment. As a certified Maximum Care Endoprosthetics Center, the department's doctors annually perform more than 1,000 surgical procedures for partial and total joint replacement. Every year, more than 10,000 patients entrust their health to the department's medical team. Whenever required, doctors from related medical specialties are involved in the treatment process. The main goal and focus of doctors is to maximally restore the patient's health and give him the opportunity to return to his usual way of life.

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Adult and Pediatric Orthopedics

The Department of Adult and Pediatric Orthopedics is the center of maximum orthopedic care and offers the diagnostics and treatment of all diseases and injuries of the musculoskeletal system. Along with the full range of modern operative and conservative orthopedics, the department specializes in hip and knee replacement surgery using the minimally invasive methods, replacement/revision of prostheses, orthopaedic oncology, foot surgery and patella problems in the patella.

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery

The Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery offers the full range of diagnostics, conservative and surgical treatment of musculoskeletal diseases and injuries. The department is a certified Endoprosthetics Center – more than 1,000 primary joint replacement surgeries are performed here annually. The surgeons of the Endoprosthetics Center also specialize in particularly complex clinical cases and revision procedures for the replacement of previously implanted artificial joints. In addition, the department has the status of the interregional Trauma Center certified in accordance with the standards of the German Trauma Society. The department has also been awarded a Certificate of Excellence from the German Orthopedic Foot and Ankle Society (DAF) in the field of foot surgery. A separate area of ​​clinical activity is the treatment of diseases, injuries and congenital malformations of the musculoskeletal system in children. Depending on the severity of the clinical case, both conservative and surgical techniques are used in the treatment of orthopedic pathologies in children. The department's medical team prefers sparing low-traumatic surgery, while open operations are performed only if other therapeutic options are ineffective.

University Hospital Tuebingen

9.2/10
location_onGermany, Tuebingen

Department of Adult and Pediatric Orthopedics

The Department of Adult and Pediatric Orthopedics offers the full range of modern diagnostics and treatment of diseases, deformities of the musculoskeletal system in patients of all age groups. The priority task of all specialists of the department is to preserve the mobility of the patient and improve the quality of his life. In the field of surgical treatment, the main focus is on joint arthroplasty, resection of musculoskeletal tumors, as well as surgical correction of spinal defects and pathologies. In addition, the department specializes in the treatment of sports injuries.

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of General Orthopedics and Orthopedic Oncology

The Department of General Orthopedics and Orthopedic Oncology offers the full range of conservative and surgical treatment of all musculoskeletal diseases. The department ranks among the largest medical facilities of this kind in Germany, as well as among the specialized authoritative departments for the treatment of bone and soft tissue tumors in the European medical arena. The treatment is carried out both on an outpatient and inpatient basis, including the outpatient operations. In addition to its successful clinical activities, the department is proud of its productive research work, which has given birth to many innovations in orthopedics, for example, the department's specialists have patented the very latest prosthetic systems, particularly in the field of orthopedic oncology.

University Hospital RWTH Aachen

8.5/10
location_onGermany, Aachen

Department of Adult and Pediatric Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics ranks among the top German medical facilities specializing in joint replacement surgery! The department offers the full range of diagnostics and treatment for patients with musculoskeletal diseases. The department treats patients of all age groups ranging from young children to elderly people. The department annually treats more than 15,000 patients, and also performs about 1,500 interventions yearly. The department has long traditions, long successful clinical experience, which contributes to its reputable status in the medical arena.

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Orthopedics and Traumatology

According to the Focus magazine, the Department of Orthopedics and Traumatology ranks among the top German medical facilities specializing in the treatment of injuries of any severity! The department offers the full range of diagnostic and therapeutic services to patients with diseases and injuries of the musculoskeletal system. The department has been certified by the German Society of Traumatology as a supra-regional Trauma Center. In addition, the medical institution is a certified Center for Gerontological Traumatology, the Center for Arthroscopy and Joint Surgery.

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of Adult and Pediatric Trauma, Hand, Reconstructive Surgery

The Department of Adult and Pediatric Trauma, Hand, Reconstructive Surgery offers all modern surgical interventions in these medical fields. The department specializes in the treatment of patients with polytrauma, pelvic surgery, endoprosthetics, cancer, reconstructive surgery and hand surgery. The department has 62 beds for inpatient treatment and 3 high-tech operating rooms for both planned and emergency operations. The prestigious certificates of the Interregional Trauma Center of the German Society of Traumatology and the EndoCert certificate testify to the outstanding quality of medical services.

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Orthopedics, Trauma and Reconstructive Surgery

The Department of Orthopedics, Trauma and Reconstructive Surgery offers the full range of modern diagnostic examinations, conservative and surgical treatment of the musculoskeletal system. The competence also includes round-the-clock medical care for patients with severe and multiple injuries. The department operates a certified Endoprosthetics Center, within which the patients undergo knee, hip and shoulder replacement surgeries. All the department's doctors have excellent qualifications and they are recognized experts in their field of competence, which guarantees the highest quality of medical service.

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of Adult and Pediatric Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics ranks among the best departments in Germany specializing in joint replacement surgery! The department offers the full range of accurate diagnostics, effective conservative and surgical treatment of all diseases of the musculoskeletal system. The scope of tasks of the department’s medical team is to conduct physiotherapeutic and rehabilitation measures.

University Hospital Duesseldorf

9.5/10
location_onGermany, Duesseldorf

Department of Adult and Pediatric Orthopedics

According to the Focus magazine, the Department of Adult and Pediatric Orthopedics ranks among the top German departments specializing in joint replacement surgery! The department offers the full range of diagnostics and treatment of various diseases, injuries of the musculoskeletal system, and their consequences. Also, the department's doctors specialize in sports orthopedics and treatment of orthopedic diseases in children of all age groups. The doctors have in their arsenal many conservative and surgical treatment methods. Many complex operations are carried out using a highly accurate computerized system

As sports become more popular, so does the number of sports injuries. Most often, athletes injure the joints. Up to 20% of all injuries are ankle ligament injuries. They are often combined with ankle fractures. These injuries are not always diagnosed on time. 50% of patients do not receive timely medical care. If left untreated, chronic ankle instability develops. It worsens the quality of life, and also leads to mobility deterioration, up to a complete fusion of the articular surfaces.

Content

  1. What ligaments can be ruptured
  2. Ankle ligament injuries
  3. Types of surgical treatment
  4. After surgery
  5. Why is it worth undergoing treatment in Germany

What ligaments can be ruptured

 

The ligaments of the ankle, depending on their location, are divided into three groups: the medial ligament complex (deltoid ligament), the lateral ligament complex (lateral ankle ligament) and tibiofibular junction ligaments.

The deltoid ligament is responsible for the stability of the internal ligamentous complex.

The ligaments of the lateral ligamentous complex are located outside the joint. The most important of these is the talofibular ligament. It prevents the extension of the foot, limits the posterior displacement and outward rotation of the talus.

The tibiofibular ligament fibers provide stability to the lower fibula and tibia by preventing outward repetition of the talus.

Ankle ligament injuries

 

The injuries of the ligamentous apparatus of the ankle joint are classified as severe injuries. According to their frequency, they are in second place after knee ligament rupture. However, the ankle experiences higher loads. The ankle joint holds almost the entire mass of the human body, and at the same time has high mobility.

With excessive sharp movement of the lower leg, it is not the ankle sprain that occurs, but ruptures of varying severity: partial and complete. Together with them, the vessels are also torn, which leads to hemorrhage into the articular cavity.

The most common type of injury is distal tibiofibular junction rupture. It is often associated with a torn deltoid ligament and an ankle fracture.

Immediately after the injury, the main symptom is pain in the ankle, but gradually it disappears. The main sign of chronic injury is a feeling of joint instability, which is associated with deteriorated proprioceptive sensitivity.

When turning the foot outward, the external ligaments are injured. The most common rupture is the anterior talofibular ligament. The calcaneofibular ligament is often affected as well.

Types of surgical treatment

 

The surgical treatment is provided using open or arthroscopic (minimally invasive) surgery. Although doctors in Germany prefer minimally traumatic methods of treatment, in some cases open surgery is required.

The aim of the surgical intervention is to stabilize the joint. Doctors use anatomical and non-anatomical reconstruction options.

The main options for surgical treatment are as follows: 

  • anatomical reconstruction of the ligaments;
  • transplantation from the peroneal tendon; 
  • static stabilization with tendon grafts. 

Most often, doctors resort to anatomical reconstruction of the ligaments. They restore the damaged structures using the patient's own tissues, donor or artificial material.

The non-anatomical technique involves stabilization using tenodesis (mobility limitation) using the tendon of the peroneus brevis muscle. These operations were developed in the middle of the 20th century. Subsequently, they were abandoned by most doctors due to poor long-term outcomes.

In 1966, the L. Brostrom procedure was developed. This is an anatomical reconstruction. In Western European countries, including Germany, this surgical intervention is still used as one of the main treatment methods. It completely restores ankle stability in 85% of cases. There have been developed some modified techniques that provide even better results. Some studies report up to 100% X-ray and clinical success.

Comparable results are provided by the Chrisman-Snook procedure. It refers to non-anatomical reconstruction options. 93% of patients feel ankle stability after this type of treatment. But there are disadvantages: after surgery, the mobility of the joint decreases due to the significant tension of the reconstructed ligament. In addition, the surgical intervention is more traumatic.

Here are some plastic surgery options, depending on what material is used: 

Autoplasty usually involves the use of the tendons of the muscles of the lower leg. This is the most common technique. The repaired ligaments are as strong as possible, and are characterized by good engraftment. However, there is a minus: additional trauma to the donor site. 

Synthetic ligament endoprostheses do not require additional trauma, but are less reliable compared to the patient's own tissues. The risk of repeated rupture is higher, especially in those who play sports. In recent years, new types of materials have been used in German hospitals. The plastic repair with these materials provides results comparable to autoplasty.

Alloplasty is a donor tendon transplant surgery. It avoids trauma to the donor site, but preservation reduces the strength of the material.

Fresh injuries of the distal tibiofibular junction require osteosynthesis. Percutaneous techniques are applicable only in the first 2 months after injury. But in the future, external fixation devices can complement the surgical treatment for ligament reconstruction, as they allow keeping the foot in a functionally advantageous position.

The surgical access is made through a skin incision about 5 cm. Doctors remove scars and remnants of the injured ankle ligaments. The second incision is made on the anterior-inner surface of the ankle and the lower third of the lower leg. The surgical needles are passed through two tibia bones and the normal ratio of the tibia bones at the joint level is restored with their help. To restore the ligament over the ankle, bone canals are made. A tendon graft is passed through them. Its ends are stretched and sutured together. The sutures run along the inner surface of the tibia.

After surgery

 

After the open surgery, the patient requires rehabilitation, which lasts several months.

Painkillers, cold, and physiotherapy are used for pain relief. Massage can also be used. 

The ankle joint is immobilized. The immobilization period reaches 2 months. It depends on the nature, severity of the injury, the presence of a concomitant ankle fracture.

After the period of rigid immobilization is over, orthoses of medium or light degree of fixation are used. They allow performing movements and starting rehabilitation activities.

The initial stage of recovery takes place in the same medical hospital where the patient received surgical treatment for the injury. Then he can continue treatment at a rehabilitation center. The main method of rehabilitation is therapeutic exercises. In Germany, exercises are selected individually for the patient, the results are monitored and the training program is adjusted every week.

The objective of rehabilitation is the complete elimination of pain, restoration of ankle function, and a gradual return to maximum physical activity. The patient regains muscle volume, musculo-articular sensitivity and a normal walking pattern.

Why is it worth undergoing treatment in Germany

 

In case of the ankle ligament rupture, both fresh and old, you can contact one of the medical clinics in Germany. This country provides accurate diagnostic methods to detect ligament injuries, tibiofibular junction, ankle fractures and other components of the injury. Doctors perform ankle surgery to relieve pain and chronic ankle instability. After treatment, you will be able to play sports again. The risk of repeated ligament and ankle injuries is minimized.

Why is it better to be get treatment in Germany: 

  • experienced orthopedists specializing in sports medicine and traumatology, who have a high reputation throughout the world;
  • sparing treatments for injuries of the ligaments, ankles, tibiofibular junction;
  • preference is given to the anatomical reconstruction options that allow doctors to fully restore ankle mobility;
  • modified types of surgical procedures with efficiency up to 100%; 
  • low risk of complications; 
  • successful treatment of combined injuries with torn ligaments and ankle injuries;
  • adequate anesthesia of surgical interventions and elimination of pain and other symptoms in the postoperative period;
  • quality care and full rehabilitation from the first days after the surgery. 

To undergo lateral ankle sprains treatment in Germany, please use the Booking Health service. On our website you have the opportunity to get up-to-date and accurate information about the cost of treatment in Germany for ankle and ligament injuries, compare prices in different German hospitals and book a medical care program at a favorable price. The treatment will be easier and faster for you, and the cost of treatment in Germany will be lower.

You are welcome to leave your request on the Booking Health website. Our employee will contact you, consult, answer all questions about the treatment of ligament and ankle injuries. We will take care of the organization of your trip abroad. We will provide the following benefits for you:

  • We will select the best German hospital, whose doctors specialize in the surgical treatment of ankle sprains and achieve the best results.
  • We will help overcome the language barrier and establish communication with the doctor of the German hospital.
  • The waiting time for the treatment of your ankle injury will be reduced and you will receive medical care on the most suitable dates.
  • We will reduce the price. The cost of treatment in Germany will be lower than usual due to the elimination of overpricing and coefficients for foreign patients.
  • Our specialists will solve any organizational issues: paperwork, transfer from the airport to the German hospital and back, hotel booking, interpreting services.
  • We will prepare your documents and translate them into English or German. You do not have to repeat the previously performed diagnostic procedures.
  • We will keep contact with the German hospital after the treatment of the ankle injury.
  • We will arrange additional diagnostics and treatment, if required.
  • We will buy medicines in another country and forward them to your native country.

While the best specialists in the world take care of your ankles, the Booking Health staff will help you reduce the cost of treatment in Germany and take care of all the travel arrangements.

Authors: 

The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. 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:

MedlinePlus

Medscape

Cochrane Rehabilitation




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