Ankle Sprain and Rupture — Open Surgery: treatment in the Best Hospitals of Germany
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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.
Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery, Hand Surgery and Rheumatology
The Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery, Hand Surgery and Rheumatology offers the full range of diagnostic and therapeutic services in its areas of specialization. The key areas of work of the department's doctors include large joint arthroplasty, arthroscopic interventions on the knee, hip, and shoulder joints, conservative and surgical treatment of foot and hand diseases and deformities, rheumatic joint lesions, orthopedic diseases in children, and musculoskeletal injuries. The key to successful clinical practice is the professionalism and unique experience of the department's medical team, combined with the advanced infrastructure and state-of-the-art equipment. The department has 5 operating rooms equipped with the latest technology. Most surgical interventions are performed using minimally invasive techniques, due to which, in the shortest possible time, the patient is verticalized, their mobility is restored, and a pronounced pain syndrome is excluded. The department annually performs more than 4,500 surgical interventions, including especially complex ones, so the specialists at the medical facility are rightfully proud of their impressive clinical experience in the surgical treatment of orthopedic diseases. Over the years, the department has gained an excellent reputation not only in Germany but also far beyond its borders.
Department of Adult and Pediatric Orthopedics
The Department of Adult and Pediatric Orthopedics provides the full range of modern diagnostic services and effective treatment methods for patients with musculoskeletal diseases. The medical facility admits patients of all age groups, including young children and adolescents. Special attention is paid to the treatment of hip and knee arthrosis, foot diseases and deformities, spinal pathologies, and benign and malignant musculoskeletal tumors, including bone metastases. An experienced team of pediatric orthopedists takes care of young patients. The specialists conduct both conservative and surgical treatments for hip dysplasia, Perthes disease, slipped capital femoral epiphysis, clubfoot, flat feet, scoliosis, bone and soft tissue sarcomas, bone fractures, and other pathologies and injuries. The department successfully performs CT-guided nerve root blocks for the treatment of back pain. When surgical treatment is required, the department's team of doctors uses sparing, minimally traumatic techniques. Modern navigation systems are used during joint replacement surgery to ensure the most accurate positioning of the artificial joint. The department strictly follows the recommendations of the German Society for Orthopedics and Trauma Surgery (DGOU), which ensures highly effective treatment.
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.
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.
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.
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.
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.
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.
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 of Ludwig Maximilian University of Munich
Department of Adult and Pediatric Orthopedics, Foot Surgery
The Department of Adult and Pediatric Orthopedics, Foot Surgery carries out accurate diagnostics, effective conservative and surgical treatment of the full range of diseases of the musculoskeletal system. The department's medical team's responsibilities also include physiotherapy and rehabilitation activities. Surgery for orthopedic diseases is performed in state-of-the-art operating rooms equipped for sparing minimally invasive and arthroscopic interventions. There are also treatment rooms for physiotherapy, including a room with a pool for swimming and physical exercises in the water, and rooms with modern exercise equipment. The excellent infrastructure allows doctors to provide high-quality treatment of diseases of the joints, tendons, and bones, thereby restoring patient mobility as quickly as possible. The department admits patients of all age groups, including children and adolescents. The medical facility has been awarded many prestigious quality certificates, including DGOU, endoCert, and EPRD certificates, and has an impeccable reputation in Germany.
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.
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.
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.
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.
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 leads to mobility deterioration, up to a complete fusion of the articular surfaces.
Content
- What ligaments can be ruptured
- Ankle ligament injuries
- Types of surgical treatment
- After surgery
- 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 the 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 and 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 an 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 a 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 the 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.
The Chrisman-Snook procedure provides comparable results. 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 using 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 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 two 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 of 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, colds, and physiotherapy are used for pain relief. Massage can also be used.
The ankle joint is immobilized. The immobilization period reaches two months. It depends on the nature, the severity of the injury, and the presence of a concomitant ankle fracture.
After the period of rigid immobilization is over, orthoses of a 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 to completely eliminate pain, restore 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 an 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 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, and 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, and 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 eliminating 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, and 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 in 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!
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