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Ankle Sprain at Foot and Ankle Clinic at DRHC Dubai

It’s a very common injury in orthopedic clinics. It can happen either from sports activities or from falling whilst walking or descending a staircase.

There are two types of sprains:

  • High ankle sprain: This is a severe injury that happens in about 10% of all sprains, affecting syndesmosis ligaments between the lower end of the tibia and the fibula above the ankle joint line.
  • Low ankle sprain: This is a less severe injury that happens in about 90% of all ankle sprains, affecting the anterior inferior tibiofibular ligaments and the calcaneofibular ligaments below the ankle joint line.
  • Ankle twist is a common injury in athletes and dancers. Basketball and volleyball players have the highest risk of ankle twist injuries.
  • An ankle sprain can lead to mechanical instability, especially in recurrent cases.
  • Ankle twists may be associated with other injuries like osteochondral lesions (ankle joint articular cartilage defect), peroneal muscle-tendon injuries, deltoid ligament injury (medial ankle ligament), and 5th metatarsal fracture.

Symptoms :

  • Swelling and ecchymosis at the lateral side of the ankle
  • Tenderness
  • Pain with weight bearing
  • Ankle instability.

The ankle x-ray isn’t always necessary for diagnosis but we should do it in some cases like inability to bear weight, tenderness at the medial or lateral malleolus or at the base of the 5th metatarsal or the mid tarsus bones

The standard views for X-rays are anterior-posterior, lateral, and mortise. There are also stress views for evaluating syndesmotic ligaments and ankle instability.

Rarely do we need an MRI scan for an ankle twist and we only use it if the pain persists in the ankle 6-8 weeks after initial sprain.

Treatment for Ankle Sprain in Dubai DRHC:

  • The majority of cases can be managed by elastic wraps or ankle orthosis for 1 week.
  • Some severe twisting may need a cast for a few weeks accompanied by physiotherapy.
  • Pain decreases rapidly during the first 2 weeks after injury, but there is an increased risk of a sprain to the ipsilateral and contralateral ankle, and in 15 % of cases there is recurrent pain after 1 year.
  • In severe cases and if the patient continues to have pain and instability despite extensive nonoperative management, we do surgery for anatomical reconstruction of the ligaments or tendon transfer to support any ankle instability present.

Prior to reconstruction we usually do ankle arthroscopy to evaluate for intra-articular pathology(anterior-inferior tibiofibular ligament impingement, posteromedial impingement lesion of the ankle, or any osteochondral lesion).

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