Ankle Ligament Surgery in Singapore
There are multiple bones in our foot and ankle which are held together with ligaments. These ligaments provide stability to our joints while we walk, climb stairs and enjoy our sporting activities. They allow us to walk on uneven ground without consciously having any ankle pain or instability.
What are ankle sprains?
Ankle sprains are common injuries we have all experienced in our life. It may have happened while we were just walking or while we were enjoying our hobbies or sport. We may have put our foot down wrongly or missed a step. Regardless of how it happened, the ankle ligaments are stretched or partially torn as the ankle is forced out of its normal position. In bad sprains, one or more of these ligaments may be completely torn with significant pain and swelling experienced after the injury.
How to tell if you have torn an ankle ligament?
There are two main types of ankle sprains, inversion and eversion injuries as shown in the picture below. With inversion injuries, you may experience pain and swelling over the outer border of your ankle. Eversion injuries are less common and patients experience pain and swelling in the inner part of their ankle.
These symptoms may last a few weeks if they are not too serious but may bother you for several months if there are partial or complete ligament tears.
Do I need an MRI scan?
If you have persistent ankle pain, swelling, and instability, you may have partially or completely torn an ankle ligament. Your orthopaedic surgeon will assess your ankle to determine the location of the tear and if your ankle is loose or unstable.
An MRI scan will determine which of the ligaments are torn and to what degree they are torn. Ligament injuries may be graded from 1 to 3, as shown in the photo below. Regardless of your tear, initial conservative management is still important. This includes Rest, Ice, Compression and Elevation (RICE).
How Do I Know If My Ankle Sprain Or Injury Is Serious?
Ankle sprains should not be underestimated. Treatment for it depends on its severity. In mild cases, self-care with rest, ice, compression, and elevation (RICE) may be all you need. However, in more severe cases, persistent pain and instability should be formally addressed by an orthopaedic surgeon.
If you experience the following, we urge you to seek medical attention as soon as possible:
- Ankle pain
- Ankle instability or recurrent (repeated) sprains while walking on flat or uneven ground
- Ankle weakness
- Difficulty walking on uneven ground
Symptoms may vary from person to person.
The ankle is a weight-bearing joint. Minor injuries which are neglected can escalate into more serious problems. Timely and appropriate treatment are crucial to treat these injuries and get you back to your active lifestyle.
How can I prevent ankle sprains?
- Warm up before exercise or sports
- Avoid sports in which you are not trained or conditioned
- Wear shoes that fit well and are appropriate for your activity
- Use an ankle brace or guard for a previously weak ankle
- Maintain good muscle strength and conditioning
- Be aware when exercising on uneven ground
How Would My Ankle Be Examined, Diagnosed, And Treated?
Examination and assessment
- Your orthopaedic surgeon will assess how you sustained the injury. Did you twist your ankle while walking, going down stairs or landing awkwardly during a basketball game?
- A thorough examination of your ankle will be performed. Any bruising or swelling around the ankle will be gently palpated to assess for pain. Your ankle will be moved to look for any stiffness or instability. Both your ankles will be compared for completeness.
- A simple x-ray of your ankle may be performed in serious cases to exclude any possible fractures
- In cases of recurrent (repeated) ankle sprains with severe pain and swelling, an MRI scan of your ankle may be performed to look for partial or complete tears of your ankle ligaments.
- Initial self-care is crucial for all forms of ankle sprains. Timely application of ice packs, compression and elevation will help reduce ankle swelling.
- Medications such as anti-inflammatories are important to reduce the swelling and pain in your ankle joint.
- Devices such as ankle braces and ankle guards provide compression and stability to your ankle while you recover. In more severe cases, crutches may be required to off-load your ankle.
- After an initial period of rest, physiotherapy and rehabilitation are important in restoring the flexibility and stability of your ankle.
- In cases of persistent ankle pain with instability despite physiotherapy and rest, surgery may be warranted to repair or reconstruct a ligament that won’t heal. This will help restore the function of your ankle and return you to your active lifestyle.
How Are Ankle Treatments Performed?
Ankle compression, icing and bracing
Physiotherapy and rehabilitation
Surgery to repair or reconstruct a torn ligament
- Treatment 1: After the initial ankle sprain, there is significant pain and swelling as the ankle ligaments are traumatized. Ankle compression and icing are crucial to prevent further swelling and worsening of the injury. Bracing provides additional support to the ankle where it is vulnerable and prevents recurrent ankle sprains. All these measures must be instituted timely to allow the ankle to heal and recover faster.
- Treatment 2: As the swelling around the ankle improves, physiotherapy and rehabilitation are required to restore the strength, flexibility, and stability of the muscles and ligaments around the ankle. Our trained physiotherapists will institute a rehabilitation program that is characterized by customized and progressive training for you. Muscles that have weakened due to the injury will be strengthened through exercise, stretching, and training. Stability and proprioception of your ankle will be restored using balancing exercises and specialized equipment. This will help you navigate uneven ground and stair climbing after your rehabilitation. These training exercises are crucial in preventing further injuries in the future.
- Treatment 3: In severe ankle sprains, one or more ligaments that hold the ankle joint together may be partially or completely torn. Despite initial treatment with compression, icing and physiotherapy, patients may still experience pain, instability and loss of function. In these instances, surgery may be the appropriate treatment to repair or reconstruct the torn ligaments and restore the stability of your ankle. A stable ankle will accelerate your recovery process as it helps prevent recurrent ankle injury and swelling. It allows you to embark on your rehabilitation with confidence and assurance.
What surgery is done for ankle ligament injuries?
Ankle ligament surgery may be required if you continue to have ankle pain, instability, and swelling despite good rehabilitation, physiotherapy, and medication. These injuries are minimally invasive procedures employed to repair or reconstruct torn ligaments.
The surgery aims to restore your ankle's stability so you may return to active sports and hobbies. These keyhole techniques involve small skin incisions with a low risk of injections and complications.
Implants such as anchor sutures are used to approximate the torn structure to the ankle bones themselves. This helps to restore the integrity and stability of the ankle.
How Long Will It Take For My Ankle To Recover?
An ankle sprain or strain can take up to 2 or 3 months to recover. This depends on the severity of the initial injury and the type of treatment you receive. An ankle fracture may take up to 2 to 3 months to recover depending on whether it was treated in a cast or operated on. A timely assessment by an orthopaedic surgeon helps to initiate treatment sooner and get you on your way to recovery.
Treatment for ankle sprains at Orion Orthopaedic Surgery is designed to accelerate your recovery with holistic and patient-centered care. Dr. Mizan will work with you to ensure you return to your daily activities and favourite sports safely and timely.
Is it alright to walk around with a sprained ankle?
This depends on the sprain's severity and what treatment has been rendered for the injury. Your doctor may advise you to only put minimal weight on your ankle while it is still recovering from the injury. Excessive walking may lead to more pain and swelling if the injury is stressed too early on.
How do I know if my ankle sprain is serious?
The nature of the initial accident or injury will provide a good idea about how fast it may recover. A serious injury is characterized by severe pain, swelling, and recurrent sprains despite efforts to support and treat it. If you are experiencing these, the soonest visit to the specialist is highly advised.
Can I claim insurance for my ankle injury?
Ankle sprains and injuries are insurance claimable. We do advise our patients to check with their personal or corporate insurance plans and representatives. We are also able to help them with this if required.
What should I do immediately after an ankle sprain while waiting for my appointment and treatment?
Timely self-care with rest, icing, compression, and elevation are important to manage the initial pain and swelling around the ankle. Anti-inflammatory medication will further reduce the pain and swelling that you may be experiencing.
I have more questions, how can I speak to a doctor?
Please call us at +65 6733 4565 (during office hours), or drop us a text or WhatsApp message at +65 9766 4565. We will reply to your queries as soon as we get them. You may also call to make an appointment to see Dr. Mizan for your ankle injury.