Your ankles are highly complex joints that are kept safely in place by their ligaments. Ligaments are strong, stretchy bands of connective tissue, which is mostly made up of collagen. Since connective tissue has a low vascularisation and as a result, doesn’t get much blood flow, injuring your ankle can lead to torn ligaments in ankle and can take a long time to heal.
Ankle ligaments become injured when they are stretched beyond their normal range. This usually occurs after your ankle twists inward or outward suddenly, generating a sprained ankle. Stepping or jumping over an uneven surface can also sprain your ankle.
Sprained ankles can range from very mild injuries to severe trauma, in which there are torn ligaments in the ankle. Torn ankle ligaments can be partial or complete, and depending on their severity, they can require surgical treatment.
There is some degree of ligament damage in all ankle sprains, but they can be classified in three grades depending on how serious the injury is.
- Grade I: ankle ligaments become partially stretched, and only micro-tears appear on the tissue.
- Grade II: these injuries cause a partial tear in one of the ankle’s ligaments. They are also characterised by an abnormal degree of laxity in the ligaments.
- Grade III: these are the worst possible ankle sprains. These injuries involve a completely torn ligament in the ankle. The avulsion of the ligament and/or ankle fractures can also occur. These injuries are very severe and usually require surgical treatment.
The treatment for the torn ligaments in ankle sprains can vary greatly depending on the severity of the injury. After the initial trauma, it’s always a good idea to apply ice and compression to the ankle while you make your way to the doctor. A podiatrist will order the necessary imaging tests to determine the grade of your sprain, the exact location of the ligament tears, and the type of treatment you will need to follow.
Almost all ankle sprains can be treated without surgery with a combination of rest, immobilisation, rehabilitation exercises and orthotics. However, fully torn ligaments in ankle sprains tend to require surgery.
Ankle Ligament Reconstruction (ALR) is one of the most common procedures used to treat torn ligaments in your ankle. In some cases, your doctor will perform an arthroscopy first to inspect the joint and pinpoint the exact location of the injury. The ALR itself is a relatively simple procedure that will help your ankle become stable again, and it is typically an outpatient procedure.
After the ALR, your ankle will need to be in a cast for a few weeks. Following this period, your podiatrist will refer you to a physiotherapist to begin a physical rehabilitation program.