Rupture of ligaments of the ankle joint: symptoms and treatment

Sprain of the ankle joint: symptoms and treatment

Experts consider the ankle to be a rather vulnerable place. After all, he has a huge load. When walking or running, it can withstand the weight of the whole body.

Possible problems

With too heavy loads or unsuccessful setting of the leg, ligaments that connect the bones may be damaged.

Problems with them are caused by the fact that they can tear themselves apart or burst completely. But in the first case, it is a question of stretching the ligaments of the ankle joint.

But when they are completely ruptured, they are already talking about a dislocation.

The diagnosis is made only on the basis of research conducted by a surgeon, visual inspection of the area of ​​damage and analysis of patient complaints.

In the picture, only the dislocation of the joint or bone fracture will be seen.

Types of stretching

Depending on the severity of the lesions, several possible degrees of injury are identified. The first is considered the easiest form of the disease. It is characterized by micro-fissures that have arisen on the ligaments of the foot.

This is all accompanied by moderate pain. Drawing sensations often occur only when the joint is stressed, for example when walking, jumping or running. In this case, the stretching of the ligaments of the ankle joint is no longer manifested.

At rest, the patient's leg does not bother.

In cases of moderate damage, partial ligation of the ligaments occurs. At the same time, the person feels quite intense pain, severe discomfort when walking, sometimes up to complete immobilization.

There is also such an extension of the ligaments of the ankle joint. Photos of patients with similar problems will help to understand how the foot looks with lesions of moderate severity.

In the region of the joint and foot, edema can be seen, often accompanied by a hemorrhage.

If the lesions are so strong that the ligaments are almost ruptured, then we are talking about the third degree. A person can not even stand on a damaged leg.

Such a strong stretching of the ligaments of the ankle is accompanied by inflammation of the soft tissues, swelling, hemorrhage.

The skin in the place of rupture is painted in a bright red color.

Symptoms of Gap

It is important to know in which situations you need to rush to the doctor, because you can not ignore the stretching of the ligaments of the ankle joint. Treatment should be scheduled immediately.

So, the main sign is pain in the ankle area. But do not forget that there are several forms of stretching, and each of them manifests itself in different ways.

It does not require in-patient treatment, but without adequate therapy, the situation may worsen.

And if the pain is accompanied by a hemorrhage and swelling, then a doctor's consultation is mandatory. After all, these are the main signs of sprain of the ankle.

Causes of problems

It is noteworthy that many people throughout their lives never face these problems, while others damage ligaments with enviable regularity.

Of course, there are people with an increased predisposition to receive such traumas. They need to be more careful.

After all, the sprain of the ankle, the symptoms of which are mostly pronounced in most cases, are, as a rule, the result of injuries. The main reasons include:

- falls;

- Strikes, sharp pressure;

- sharp physiologically incorrect turns of the foot, often this happens when moving over uneven surfaces;

- Turning the legs due to uncomfortable or incorrectly selected shoes.

In certain sports there is an increased risk of injuries and sprains of the ankle. They include hockey, football, parkour, gymnastics, parachuting and others.

Risk factors

In addition to the main causes that can cause stretching of the ligaments of the ankle joint, there are also predisposing factors for this. They include frequent stretching.

Because of them, the system holding the joint in place is loosened. A number of minor injuries, especially those left unattended, can result in serious ankle injury.

Also, the risk factors include congenital pathologies: excessive weakness of ligaments, a high arch of the foot, various diseases.

Diagnosing problems

Disregard any discomfort in the ankle area is strictly prohibited, if you do not want to get serious injuries and remain with a defect in the musculoskeletal system.

It is important to know that it is almost impossible to diagnose the severity of problems independently without special medical education.

Therefore, it is necessary not only to go to the examination to the surgeon or traumatologist, but also not to refuse X-rays or MRI, if they are appointed by a specialist. If the doctor sends for additional research, then the situation is serious enough.

Necessary treatment

It is important to know how problems can appear and what to do if you suspect that you have an ankle sprain.

Treatment in the first place is to use dry cold.

Doctors recommend applying ice, wrapped in a soft cloth, to the painful place for 15 minutes hourly throughout the first day after the injury.

Also, if possible, it is necessary to immobilize the ankle. For this, an 8-band dressing is applied to the injured area, but it should not be too tight. Take care not to squeeze the blood vessels.

A photo of your own foot, made on the first day after the injury and after a while, will help you determine how quickly the hemorrhage goes away and the swelling subsides.

By the way, it is warm compresses that improve blood circulation and contribute to the fact that recovery is faster.

Treatment of first degree injuries

As a rule, with light injuries, there is enough bandage applied to the leg and rest for 2-3 days. During this time, the articular tissue is restored, and a person can return to normal life.

But even in these cases the doctor can recommend using an analgesic ointment.

The stretching of the ligaments of the ankle joint is accompanied by unpleasant sensations, even in cases when the injuries are not too strong.

It can be recommended ointment "Voltaren" or "Diclofenac which can be used until all the discomfort disappears. To improve venous outflow appoint gels "Heparin "Troxevasin "Lyoton."

When stretching the first degree on the first day cold is applied, and starting from the second day, the use of thermal compresses is possible.

Already on the 3rd or 4th day the fixative bandage can be removed, and the patient should start rehabilitation, which consists in performing a series of gymnastic exercises.

Simultaneously with the onset of motor activity, warming ointments can also be used, for example, "Capsicum" or "Apizarthron".

Treatment of second degree injuries

If you have a sprain of the ankle joint that bothers you even at rest and interferes with normal walking, the doctor will prescribe more radical therapies.

For three, and sometimes four days, it is necessary to apply ice. In this case, the joint is immobilized for a period of two weeks. For anesthesia, ointments are practically not used, doctors prescribe tableted medicines.

To facilitate discomfort, the drug "Ketanov" can be recommended.

Heat is used no earlier than 3-4 days. Active movements with loads are prohibited for the duration of treatment.

To recover often helps not only exercise therapy, but also prescribed physiotherapy.

Therapy for third degree injuries

If the doctor suspects that you have an ankle sprain, then most likely you will need not just a doctor's examination, but additional studies, such as an x-ray or an MRI.

When you confirm that you have a partial or complete rupture of the ligaments, you will be plastered, not elastic bandages. In some cases, surgical intervention is necessary.

With its help restore the fibers of the ligaments.

They immobilize the injured leg for a period of 4-6 weeks, depending on the severity of the ruptures. Often treatment is carried out in a hospital. Recovery takes a long time. The period can last for 3-6 months.

If you have pronounced symptoms of sprains in the ankle joint, and you suspect that there may even be a rupture, it is important to start therapy in a timely manner.

In a hospital environment, non-steroidal anti-inflammatory drugs may be prescribed. This could be Ibuprofen, Ketorolac, Nimesulide.

In some cases, injecting drugs such as Novocain, Lidocaine, Hydrocortisone are recommended.

If an excessive amount of blood is accumulated in the ankle, a puncture can be performed. At the same time, the liquid is sucked off with a syringe, and the Novokain solution is injected into the injury site.

An important role is given to physiotherapeutic procedures. This is especially true for patients who have a rupture or a strong sprain of the ankle.

Photos of patients' legs before and after such events vary significantly.

This indicates that the prescribed therapy promotes a more rapid recovery.

Physiotherapy and exercise therapy

To speed up recovery, often in a hospital setting, doctors prescribe additional therapy. The most popular methods of treatment include paraffin applications, current, UHF.

For example, if you have a sprain of the right ankle joint, electrophoresis with a raster of potassium iodide can be assigned to this area. In certain cases, anesthetics are used. Also can do warming applications with ozocerite.

But the treatment must be secured. For this purpose special gymnastics is intended.

LFK is also necessary for muscle recovery after a long period of immobilization, improving their performance, activating the circulatory processes.

A source: https://www.syl.ru/article/168868/new_rastyajenie-svyazok-golenostopnogo-sustava-simptomyi-i-lechenie

Rupture of ligaments of the ankle joint: treatment, symptoms, photo

Ankle joint of a person takes on a significant part of a person's weight.

That is why it is surrounded by numerous muscles and tendons, which give it stability and reliability.

Nevertheless, the rupture of the ligaments of the ankle is the most common trauma of the musculoskeletal system. Why?

1. Causes of trauma
2. Treating trauma correctly

Causes of trauma

• Sedentary lifestyle. The consequence of sedentary and sedentary lifestyle is the destruction, decrepitude and atrophy of the musculoskeletal system.
• Elderly age. It increases the risk of injury several times, because over time, the muscles of the body become less elastic, the bones are more fragile, and the ligaments are weaker.

ankle joint with ligament rupture

Also, the rupture of ligaments of the ankle joint can result in employment in traumatic sports, inaccurate walking with foot turn, jumping from height, etc.

Types and symptoms of trauma

By the number of broken fibers, the ligament rupture of the ankle can have several degrees:

1. With a slight degree of trauma, the so-called stretching, a small part of the fibers in the ankle is ruptured, i.e. there were microscopic ruptures. This degree is accompanied by minor painful sensations during movement and, possibly, a slight reddening of the skin near the joint.
2. The second degree of injury - a partial rupture of the ligaments indicates damage to most of the fibers in the joint. In this case, the patient may have great difficulty walking or will not be able to walk at all.
3. With an extreme degree of trauma, a complete rupture of the ankle ligaments occurs, which leads to a disruption in the motor function of the joint and the patient can not move independently. The joint increases in size due to the large puffiness of the outer side of the ankle and the foot. There are bruises and bruises in the ankle.

Treating trauma correctly

The effectiveness of trauma treatment depends on the degree of damage that the doctor determines in the trauma clinic.

Diagnose the rupture of the ankle joints by using:

• Radiography, which results in the detection of ankle bias or fracture of the joint;
• MRI - helps in assessing the degree of injury, because gives a layered image of all ligaments, tendons and injured joints.

Treatment of an easy degree of rupture of ankle ligaments is reduced to a tight bandage of the joint and the use of drugs that have a targeted effect on the connective tissue of the ligaments.

Complex treatment of trauma also implies compliance with the diet. During the rehabilitation, the body needs an increased amount of protein, which is rich, for example, meat and dairy dishes.

Restoration of the function of the joint in this case takes about 7-10 days.

With partial rupture of the ankle ligament, the use of pharmacological agents is topical.

Treatment is carried out according to the scheme: protection of the joint from the load - medication - rest - use of a pressure bandage or a tire - exercise therapy - rehabilitation.

With excessively strong pain, injections of a solution of novocaine, lidocaine and hydrocortisone are used.

Medicamental treatment of partial rupture of the ankle ligaments is carried out with the help of nonsteroidal anti-inflammatory drugs: ibuprofen, ketorolac, nimesulide, etc.

The procedure of puncture with the evacuation of excess blood is indicated in case of significant hemorrhage in the ankle joint cavity.

A protective eight-part bandage or splint with partial rupture of the ankle joints is recommended to be worn for 2-3 weeks until the edema and pain disappear completely.

Complex treatment of ankle injury implies the use of such physiotherapy methods as diadynamic currents, paraffin applications, UHF therapy, etc.

Treatment of complete rupture of the ankle ligaments, as well as massive hemorrhage into the periarticular tissues and open trauma with ligament rupture implies surgical intervention.

In the course of surgical intervention, the damaged ligaments are sewed or the ends of the ligaments are sewn to the bone, the joint cavity is inspected and the damaged tissue is resected (removed).

Conclusion

Correctly diagnosed extent of injury, competent approach to treatment, careful performance of patients the doctor's recommendations lead to a rapid recovery of the ankle ligament and minimize the consequences after injury.

The effectiveness of the treatment of ankle rupture is also in the practice of physical therapy, physiotherapy, massage and taking warm baths during the rehabilitation stage. Individual approach to the complex of exercises, early physical activity, guarantee a quick recovery of the joint.

A source: http://sustavu.ru/sustavy/golenostopnyj/razryv-svyazok-golenostopnogo-sustava.html

Treatment of rupture of ligaments of the ankle joint, whom to contact

The rupture of the ankle ligaments is a dangerous, but at the same time quite a frequent trauma.

This is due to the fact that the joint is regularly high load. In addition, the ankles are in constant motion.

And any careless action can provoke an ankle ligament.

Symptoms and treatment, as well as the consequences of this problem are largely determined by the severity of the ankle injury. It is important to understand that this trauma is serious enough. Sometimes it is difficult to predict how much the ligaments heal.

Causes of ankle ligament rupture

It should be noted that the rupture of the ligaments of the ankle is a complete or partial damage to the fibers of the ligaments. The bones of the ankle are supported by three groups of tendons. Each of them ensures the correct position of the talus bone.

It is important to understand that damage to the ligaments of the ankle joint is of several kinds.

Stretching is characterized by a partial rupture of individual fibers, for example, the peroneal ligament. And if a lot of fibers are damaged, there is a tear.

In this case, the joint itself remains functional, however, with certain limitations.

The formation of gaps in the ankle joint is possible for a number of reasons. Most often this problem occurs:

1. During sports exercises (running, jumping and so on). With these actions, the ligaments of the ankle are subjected to enormous loads. If a person makes large-radius motions, the probability of a rupture increases many times. For example, lovers of ski sports often seek medical attention for the treatment of ankle ligament injuries located outside the muscle group.
2. Careless movements in everyday life. Ankle rupture in the home is due to, for example, slipping on the wet floor or the transfer of heavy objects.
3. Wearing uncomfortable shoes. In this case we are talking about shoes in which the leg is at an unnatural angle (high heel and the like).

In general, there are a lot of reasons for the appearance of the trauma under consideration. Part of the problem arises from the fact that the ankle joints were not prepared for large and prolonged loads.

It is worth noting that not all tendons in the ankle are injured because of the reasons discussed above.

For example, the deltoid ligament rupture is possible only with an ankle fracture. Therefore, it is so important after an injury to the ankle to seek help from a doctor.

Degrees of damage

The treatment for rupturing the ligaments of the ankle is determined by the severity of the injury. In medical practice, it is common to divide the latter into 3 degrees:

• In another way, this trauma is called sprain. Such damage is characterized by rupture of a small number of fibers.
• Partial rupture of ligaments of the ankle. The second degree is characterized by the preservation of the functionality of the tendons, but at the same time a greater number of fibers are damaged.
• With such a trauma, the tendons lose their efficiency for a while. In particularly difficult cases, the ligament is detached from the attachment site, as a result of which the ankle joint ceases to function.

Symptoms of ankle ligament rupture

What symptoms are reported that a person has torn ligaments on the ankle? The first and the main sign, indicating the rupture of ligaments in the ankle, is the appearance of pain syndrome. Its severity, as well as the strength of the manifestation of other symptoms, depends on the extent of the lesion.

1. At the first degree - the symptoms of rupture of the ligaments of the ankle joint are weakly expressed. Painful sensations arise when walking and practically do not cause problems for a person. Moreover, the pain can disappear if the patient walks for a long time. In other words, if you actively load the ankle, the pain disappears briefly. But also this sensation arises at a weak pressing on the amazed joint around which in due course there is a small tumor.
2. The second degree of rupture of the ligaments of the ankle joint is characterized by a larger area of ​​damage. Edema moves to the side and front of the foot. In the movement, a person experiences quite a lot of pain. Walking becomes more difficult.
3. At the third degree of rupture of ligaments, very severe pain is observed, increasing with the load on the joint. Even a weak movement can cause serious discomfort. Edema spreads to the entire foot, including its plantar part. When the ligaments of the ankle joint of the third degree break, internal bleeding is often formed, which manifests itself in the form of hematoma. The motor functions of the foot are lost almost completely.

On the X-ray, bone visible in the wrong place can be seen. This indicates the separation of the ligament from the attachment point.

Methods of treatment

How to treat torn ligaments of the ankle joint? Therapy, as well as the symptoms resulting from the rupture of the ankle ligament, is determined on the basis of the extent of the lesion. The same circumstance influences the recovery time after an injury.

Treatment of the initial degree of joint damage

With a weak lesion of the tendon of the ankle, treatment is carried out at home.

First of all, it is necessary to reliably fix the injured part of the limb by applying a tire or elastic bandage.

Next, ointments that have anti-inflammatory and analgesic properties are used.

In the first two days after injury, the use of cooling preparations such as Chlorethyl and menthol gels is recommended. The use of warming ointments and compresses is strictly contraindicated. The therapeutic effect of cooling ointments is due to their composition, which contains:

• menthol;
• anticoagulants;
• analgesics;
• alcohol;
• essential oils.

Such ointments effectively blunt the pain syndrome. Means must be rubbed while performing massage movements. To remove the edema, it is recommended to apply ice regularly to the affected area within two days.

Eliminate inflammation in the rupture of ligaments of the ankle joint allow Troxevasin (possibly a combination of ointments and tablets) and Venoruton. Preparations are quickly absorbed and do not warm up the joint.

After two days, warming medicines are used. For these purposes, recommended ointments (gels) and traditional medicine in the form of lotions and compresses.

Vodka or milk

To make a compress, you need to moisten a piece of gauze in vodka or milk, and then put the tissue on the affected area. Then it should be wrapped with polyethylene. The first time the compress is left overnight. In the future, the drug is recommended to be used for 3-4 hours daily.

Cooking salt and onions

It is necessary to grind two medium sized bulbs, add a tablespoon of salt to the resulting slurry and spread the resulting mixture into several layers of gauze.

Then put it on the joint, at 1 hours. This procedure should be repeated up to 6 times a day.

Under the conditions of treatment and regular use of medicines (ointments, compresses), rehabilitation is completed after 10-14 days.

Treatment of the second degree of rupture of ligaments of the ankle

In this case, it is more difficult to determine in advance how much the affected joint will heal. It depends on how much fiber was damaged.

To avoid worsening of the situation, doctors recommend wearing a plaster langet. It well fixes the ankle and speeds up the recovery process. Treatment of ligaments of the ankle joint with a second degree lesion is also performed at home.

To speed up the treatment of ankle damage, physiotherapy procedures allow. It can be:

1. UHF;
2. exercise therapy (LFK);
3. Warm baths that help to relax the muscle fibers.

The duration of the recovery period is often about 3 weeks.

Treatment of the third degree

A severed joint causes severe pain, which must be removed with appropriate ointments. For these purposes, it is also possible to take painkillers. In particular, the injection of novocaine, which allows to eliminate pain for a day, is recommended.

When the ligaments of the ankle joint of the third degree are broken, internal bleeding is usually observed. Blood clots are eliminated by means of a puncture, which prevents the penetration of the infection and the development of the inflammatory process.

To relieve pain and shorten the recovery period, the following physiotherapy procedures are prescribed:

• UHF;
• electrophoresis, during which calcium is applied;
• ozokerite;
• magnetotherapy;
• massage;
• treatment with paraffin and mud.

Physiotherapy allows to restore the structure of fibers, to accelerate the exchange of nutrients, due to which their intergrowth is activated. Treatment of complete rupture of ligaments of the ankle joint takes about three months.

A source: https://NaNogah.com/injury/razryv-svyazok-golenostopnogo-sustava.html

Sprain of the ankle joint: symptoms and treatment

The ankle joint is designed in such a way that it has a large amplitude of movements in various planes, and also carries a heavy load when walking, running, lifting and carrying weights, playing sports.

The injuries of this joint are quite common, especially partial damage to the ligament apparatus or its extension. In fact, the ligaments are not able to stretch, they tear. Stretching of the ligaments is called ruptures of their individual fibers, which do not violate stability.

But even such a trauma requires immediate therapy and subsequent rehabilitation. P>

The structure of the ankle

This joint is a block formed by the ankles and the talus bone.

Between them, as well as the bones of the foot, there are ligaments: between the tibiae are the intercellular bones, inner side - a large deltoid ligament, from the outside - talon-peroneal and heel-peroneal. They consist of collagen and ellastic fibers, due to which they stabilize the joint and simultaneously allow it to perform complex movements.

Causes and signs of sprain

Bunches can be damaged by turning the foot outward (peroneal group of ligaments) or inward (tibial, or deltoid).

Such mechanisms are triggered when walking or running on uneven terrain, while playing sports (football, skiing, athletics), while wearing high heels.

The load that the bundle is able to withstand is beyond the possible limit, then the fiber breaks. Often there is an extension of the outer group of ligaments.

Who is at risk for trauma to the ligament apparatus of the ankle? These are people with excessive body weight, degenerative joint changes, metabolic disorders, pronounced flat feet, clubfoot, having previously traumatized ankle joint.

When the ligaments are stretched, the clinical picture is poorly expressed. The victim can move independently, lean on the leg, but it is painful, there is a limping. Gradually, in the area of ​​injury, edema develops, a small bruise may appear, i.e. hemorrhage into the subcutaneous tissue, increase in local temperature. The movements in the joint cause pain. And, often a person does not immediately begin to worry about the damage, he does not reduce physical activity.

The next day, because of the increase in post-traumatic inflammation and hematoma, complaints appear.

The sprain usually heals after 10-14 days.

Diagnostics

To correctly diagnose, the doctor interviews the victim about the nature of the pain, the mechanism of injury, and also conducts a series of clinical tests. In some cases, an ankle is X-rayed in two projections to exclude a fracture.

Treatment

Peace and cold. These are the principles of first aid for any ankle injury. It is necessary to fix the foot in a fixed position. If there is a slightest suspicion of a fracture, the joint is deformed, then it should be scanned with the help of improvised means.

The victim should not give full support to the foot, until a diagnosis is established. Cold should be applied for 10-15 minutes, after an hour and a half to repeat. This will avoid a pronounced hemorrhage into the soft tissues of the damaged ligament fibers, and also reduce pain.

You can wrap ice, a container of cold water or a frozen product from the freezer in the towel. It is advisable to use cold in the first two days after the injury. If the ligaments are stretched, the ankle should be bandaged with an eight-fold elastic bandage, but not too tight.

Further, the doctor will appoint an elastic bandage or a fixative bandage in the form of a sock with open toes and a heel. The duration of wearing a bandage is 7-10 days. At night, the means for fixing the joint should be removed.

After injury, give your leg an elevated position, placing it on a pillow or on a chair.

1. For pains and marked edema, non-steroidal anti-inflammatory drugs are shown inside, for example, ketoprofen, or athera, or nise in a dosage of 100 mg 1 tablet 2 times daily after meals. Such drugs are best taken as prescribed by a doctor. The course of treatment is 7-10 days. Locally recommended ointments with a similar action (doloben, diclac, ketonal) 3-4 times a day for 10-14 days.
2. After two days you can apply dry heat (salt or sand, heated on the stove and placed in a rag bag, or a heating pad) for 30-40 minutes, half-alcohol compresses for 1.5-2 hours before bedtime.
3. The recovery period can begin 7-10 days after the injury. It includes physiotherapy (magnetotherapy, phonophoresis with hydrocortisone, paraffin applications), curative gymnastics, warm baths, foot, ankle and shin massage.

Errors of patients in the treatment of sprain in the ankle joint

• Thermal procedures in the first week after the injury (both dry heat, and steaming, hot tubs);
• an attempt to "develop" the joint through pain, non-compliance with the sparing orthopedic regimen, joint massage the first few days after the injury;
• use of the bandage at rest while sleeping.

Preventive measures

It is impossible to completely prevent the stretching of the ligaments of the ankle joint, as well as any other trauma. But there are some recommendations to reduce the risk of damage:

Untreated stretching of the ligaments of the ankle joint can lead to repeated injuries, joint arthrosis, which is already an irreversible process. Therefore, it is very important to carry out examination and damage therapy on time.

To which doctor to apply

If you have damaged the ankle joint, stretched the ligaments, you need to go to a traumatologist and do an x-ray to exclude a fracture. In the future, the family doctor can monitor the progress of recovery. In the treatment, physician-physiotherapist, masseur, manual therapist also participate.

A source: https://myfamilydoctor.ru/rastyazhenie-svyazok-golenostopnogo-sustava-simptomy-i-lechenie/

Damage to the ligaments of the ankle

Damage to the ligaments of the ankle- quite a frequent injury. Sprains, tears and ligament ruptures account for 10-12% of the total number of ankle damage.

Most often, the injury occurs in the winter when you turn the foot on ice, icy steps and platforms. The injuries to the ankle joints account for about 19% of all sports injuries.

The clinic of injuries of the ligaments of the ankle joint depends on their severity (stretching, tearing, full rupture). As a rule, it includes local puffiness, pain, varying volume of movements in the joint and walking disorders.

The treatment can be used physiotherapy methods, the imposition of gypsum longes, therapeutic punctures, warm baths and massage.

Damage to the ligaments of the ankle- quite a frequent injury. Sprains, tears and ligament ruptures account for 10-12% of the total number of ankle damage.

Most often, the injury occurs in the winter when you turn the foot on ice, icy steps and platforms.

In addition, ligament damage can occur as a result of a jump from a height (often a small one) or walking along an uneven surface. Damage to ligaments can be combined with subluxation or dislocation of the ankle joint.

Damage to the ligaments of the ankle joint is one of the most common sports injuries (about 19% of all injuries in athletes).

Anatomy

There are three groups of ligaments that take part in fixing the ankle joint. On the external surface of the joint are heel-peroneal, anterior and posterior the talon-peroneal ligament that extend along the external ankle and keep the talus bone from lateral displacement.

On the inner surface of the joint passes a deltoid (inner collateral) ligament, consisting of deep and surface layers. The superficial layer is attached to the ram's and navicular bones, the deep layer is attached to the inner part of the talus bone.

The most common damage to the external group of ligaments (usually suffers anterior talon-peroneal ligament).

Classification of ankle ligament injuries

There are three types of damage to the ligament apparatus of the ankle joint:

• Rupture of individual fibers. In everyday life such damage is usually called stretching the ligaments of the ankle, however, this name is not corresponds to the actual state of things, since the bundles are completely inelastic and can not stretch.
• Ankle ligament tearing. A significant portion of the fibers are torn, but the ligaments continue to perform their supporting function.
• Complete rupture of ligaments of the ankle joint or their detachment from the attachment site.

All three types of ankle ligament injuries are accompanied by the same clinical signs, however, the severity of these symptoms directly depends on the severity of the lesion.

A patient with an ankle joint injury complains of pain while walking. Visually, swelling and bruising in the area of ​​damage is detected. Palpation of injured ligaments is painful.

Possible hemarthrosis.

When the ligaments of the ankle are stretched, the edema is local, the victim experiences pain, but remains able to walk. When the ligaments of the ankle are torn, edema spreads to the outer and anterior surface of the foot. Walking is difficult because of pain.

A complete rupture of the ligaments of the ankle joint is accompanied by hemarthrosis, marked by swelling, bruising, extending to the dorsum and plantar surface of the foot. Walking is hampered, sometimes impossible due to pain.

The inconsistency of the ligaments is confirmed by the positive symptom of the "drawer for testing which the doctor with one hand holds the patient's shin, and the other - moves the foot.

When the anterior portion of the lateral ligament ruptures, the foot is displaced anteriorly. With the rupture of the lateral ligaments, there is an increase in the lateral mobility of the foot.

The study is conducted by a traumatologist in comparison with a healthy joint.

Treatment of ankle ligament injury

Treatment of the first and second degree of damage to the ligaments of the ankle joint is performed on an outpatient basis. A patient with a sprain of an ankle joint is recommended to apply a tight eight-band dressing to the joint.

In the first two days from the moment of injury to the place of damage apply cold, and then - heat. From 2-3 days, physiotherapy is prescribed (massage, ozocerite and paraffin applications, alternating magnetic field). The patient is allowed to walk.

A tight bandage will be most effective only if you observe the technique of its application.

With sprains of the ankle joint, work capacity is restored in a period of 7 to 14 days.

When tearing the ligaments of the ankle joint, the plaster of the patient is impregnated with a gypsum longite for a period of 10 days. Physiotherapy is prescribed from 2 to 3 days after the injury.

For the time of treatment, the plaster is removed. Workability is restored after about 3 weeks.

Patients with complete rupture of the ankle joints are hospitalized in the department of traumatology. In severe pain, 1-2% of novocaine is injected into the area of ​​injury.

With hemarthrosis, a puncture is performed to remove blood and insert 10-15 ml of novocaine into the joint. On the leg impose a plaster longure for a period of 2-3 weeks.

Assign UHF to the area of ​​injury.

To improve the nutrition of the damaged area, the patient is advised from the first days to move his toes, strain the muscles of the lower leg, bend and unbend the knee joint.

After removing the bandage prescribe LFK, massage and warm medical baths.

Within two months of the injury, a tight bandage is shown to completely repair the ligament and prevent its repeated ruptures at the site of healing.

A source: http://www.krasotaimedicina.ru/diseases/traumatology/ankle-injury

How does the ankle joint rupture?

Ankle ligament tear at the turn of the foot

Ligaments of the ankle are special tendon cords, the function of which is to ensure the stability of the joint. They fix bones among themselves, prevent the pathological displacement of their surfaces relative to each other.

Tendon cords are strong, but not elastic, so tearing occurs, a rupture of ligaments of the ankle joint: partial or full, but not stretching, as is often mistakenly called this pathology.

Groups of ligaments of the ankle

The ligaments that fix the ankle joint are grouped into three groups:

1. first groupunites heel-peroneal, anterior and posterior talon-fibular ligaments running along the surface of the external ankle. They prevent lateral displacement of the talus;
2. second groupis represented by a deltoid (inner collateral) ligament, which has two layers: superficial, attached to the scaphoid and talus bone and deep, which is attached to the talus from the inside;
3. third groupunites the syndesmosis of the intercostal, posterior transverse ligament and inter-tibial cords: posterior and anterior.

External groups are most often damaged, especially the front talon-peroneal ligament with the turn of the foot, sports injuries, jumps, falls.

At risk of an ankle injury are women who have to walk for a long time in high-heeled shoes, the elderly because of a weakened locomotor system with degenerative changes and megapods, children with large veps and congenital foot deformities: flat-footed or clubfoot and after previous injuries ankle.

Classification

Classification of injury by degree is presented in the table below:

Degrees of injury	Description of trauma and symptoms
I - easy	The minimum percentage of fibers is broken. There is moderate pain, minor swelling, slight lameness. Hematomas are absent. The ability to move is maintained.
II - medium	The fibers are torn (not completely broken), their significant part is damaged, which leads to a pronounced pain and a significant decrease in the operability of the ligament, but its supporting function is partially is retained. Puffiness appears on the foot and lower third of the shin, accompanied by a small hematoma of soft tissues. Movement in the foot is limited, and the gait in the affected person changes.
III - Heavy	The fibers are completely torn or torn from the place of attachment. It is possible to detach along with a piece of bone tissue. Injury is accompanied by sharp unbearable pain, bruising, bruising, swelling of the ankle and foot from the outside. It can become complicated by a dislocation (see Fig. Dislocation of the ankle joint: diagnosis and treatment), subluxation, intraarticular fracture. The skin temperature in the epicenter of injury rises. The victim can not move his foot and step on his foot.

On the photo, a complete rupture of the ankle ligament

Such damage as the rupture of the deltoid ligament of the ankle (internal collateral) is not common, but it can only be diagnosed by X-ray.

Figure 3 indicates the location of the deltoid ankle ligament

The rupture occurs as a result of a complex trauma with an external turn of the ankle and fracture of the tibia.

To eliminate the damage, under abdominal anesthesia, abduct the foot in the ankle and sew the fibers with lavsan threads or use local tissues for plastics. If necessary, a gingival langet is applied for up to 60 days, and during the rehabilitation, an orthosis is prescribed to limit movement in the joint.

Orthoses for the ankle

In the ankle, there are also inferior bone joints, they are retained due to interlayers or strands of connective tissue - dense syndesmosis in the form of a membrane (membrane). In case of trauma, an ankle joint syndrome may break.

First aid

If the ligament fibers are damaged, the following manipulations are performed:

• they take off their shoes, reveal a painful place;
• bend the foot at a right angle to the shin and apply a fixative bandage;
• provide peace to the victim and apply ice to the injury to reduce pain, swelling and bruising.

Bandage of an ankle bandage from an elastic bandage

The next step is the transportation of the victim to the nearest trauma center (point), where the doctor will inject an anesthetic drug, will diagnose the injury.

Diagnosis of pathology

Before the appointment of treatment, rupture of the ankle joints is confirmed by examination, X-ray, CT and MRI.

The hardware methods make it possible to determine the degree of damage to the fibers of the strands.

Treatment of ligaments in terms of severity

To medicamental and physiotherapeutic treatment, as well as with the first degree of severity of damage, add:

1. Injection blockades inside the ankle cavity and the area of ​​damaged strands of Novocain or Lidocaine;
2. manual therapy using muscular and articular techniques;
3. lubrication of the pain zone with analgesic ointments and gels: Ketonalom, Dolobien, Naize and others;
4. teiping (see Joint tapping: a new progressive method of treatment and rehabilitation), wearing bandages and orthoses;

Elimination of ankle pain by typing

• therapeutic baths, compresses, applications;
• diadynamic currents, mud mud;
• puncture in the detection of blood in the joint cavity and its evacuation;
• arthroscopy of the ankle (if necessary);
• passive and active physical exercises for joint development and recovery of the amplitude of movements.

Arthroscopy of the ankle

Under local or general anesthesia, a surgeon performs 2-3 punctures to introduce an arthroscope with a camera and lighting, and micro instruments. Then follows the removal of damaged (torn off) tissues and strands, stitching and / or hemming them to bone tissue.

Apply operative treatment of a rupture of ankle joints of the third degree in case of complications:

1. dislocation of the talus in relation to the tibia;
2. divergence of the syndesmosis of the intercellular (the distance between the tibia: large and small;
3. damage to syndesmosis in combination with an ankle fracture.

If necessary, fix the tibia with a screw and remove it after 6-8 weeks. When the syndesmosis of the ankle is ruptured, the anterior intercellular ligament is stitched and additionally fixed with a cortical screw.

It is injected over the syndesmosis parallel to the joint line through both tibia bones. More severe injuries require the introduction of 2 screws and ligament ligament sindesmosis. Cortical screw is also introduced in the case of a Mesonne fracture to stabilize the syndesmosis, excluding its compression.

The screw is inserted through a plate opening above the syndesmosis (parallel to the slit) at an angle of 30 ° from the rear and fixed in three cortical layers: lateral and medial tibia and lateral tibia.

Therefore, the small screw is not removed prematurely.

X-ray diffraction pattern of interstice syndesmosis

The price of surgical treatment depends on the degree of damage to the ligaments, accompanying pathologies and fractures. Postoperative treatment in the third stage is carried out, as indicated above in the table for the first two stages of the pathology.

How to conduct an ankle typing, you can look at the video, the exercises are given on the video:

Active development of ankle ligaments

Rehabilitation at home

After carrying out passive exercises with the help of "good hands" you should perform:

• movements of the toes, movement around the room, pulling on socks and slowly sinking to the heel;
• lifting on the socks and lowering on the heel, pulling the socks with simultaneous movement on the heels;
• use an elastic band, putting it under the toes of the foot, pulling and performing flexion-extension in the ankle joint;
• movement by turning the heels in and out;
• running around the room slowly and easily, excluding jerks and sudden movements of the foot - 15 min;
• jumping, if there is no feeling of discomfort and pain.

If I periodically experience pain during the rehabilitation period, and there are no painkillers at hand, you can take advantage of the recipes of traditional medicine.

Relieve pain, swelling and inflammation:

1. compresses from hot milk;
2. applications of gruel onions (2 heads) and sea salt (1 tbsp. l.), fix the mixture with a film and a warm cloth;
3. a pack of grated potatoes and onions with sauerkraut;
4. a leaf of cabbage, greased with vegetable oil and sprinkled with baking soda, it is put on the night and fixed with a warm scarf;
5. a compress made of crushed garlic, apple cider vinegar and ethyl alcohol, pre-mix for 7 days in a cool place, then shake before use and compress for 20 minutes. Perform 3 times a day;
6. ointment based on animal fat, powder from the leaves of eucalyptus and crushed garlic. Withstands ointment as a compress for 30 minutes;
7. ointment based on mummy (, g) and pink essential oil (5 drops). Ointment rub with light massage movements;
8. baths from broth geranium (2 tbsp. l. for 1 liter of boiling water), boil for 3-5 minutes and filter, take 20 minutes.

Complications after ligament rupture

The consequences of rupturing the ligaments of the ankle joint, complicated by injuries of the joint itself, can be as follows:

• the foot podvorot is repeatedly repeated with repeated damage to cords, nerves and blood vessels;
• develops arthrosis or arthritis;
• bone osteophytes are formed and grow;
• dense scar tissue is formed;
• inflamed soft tissue surrounding the cords and bones of the joint;
• manifested chronic hemarthrosis;
• partially atrophy muscles, and blood circulation is disrupted;
• decreased mobility of the joint after healing of ligaments;
• pain occurs with long walking or doing exercises;
• there is an external instability of the talus bone.

In case of complications, conservative-medicinal or surgical treatment is performed. Gradually resume active exercises.

Conclusion

To avoid rupture of the ankle ligament apparatus, it is necessary to exclude shoes with worn out heels on the outside, avoid training in a tired state, without prior rest and warm-up, watch the weight of your body and adhere to a healthy power supply. The main thing is to walk carefully on uneven surfaces, dirt roads, etc. and play sports in fitness centers at least 3 times a week, and physical education - every day.

A source: https://vash-ortoped.ru/travmy/razryv-svyazok-golenostopnogo-sustava-256