It May Not Be a Simple Sprain
An ankle sprain is one of the most common orthopedic injuries. There are an estimated 2 million ankle sprains that occur in the United States alone each year; the majority of these sprains will heal very well with conservative treatment. However, there are numerous additional injuries around the ankle and foot that may occur along with an ankle sprain. As such, a follow-up with an orthopedic foot and ankle specialist is highly recommended after an ankle sprain.
First Steps After Injury
At the initial visit following an ankle sprain, a patient will have x-rays taken and a thorough physical examination of both ankles and feet. Immobilization in a brace, boot or splint may be necessary. Crutches or a knee scooter might also be prescribed depending on the severity of the injury. Close clinical follow-up, including repeat clinical evaluation and physical therapy, is often needed for successful conservative management.
When Conservative Care Isn’t Enough
Occasionally, particularly severe injuries or the existence of persistent instability may indicate the need for further imaging including MRI or CT scan. About 10% to 20% of ankle sprains do ultimately require surgical management. The decision for surgery is one that is taken with the utmost care and attention to not only the patient’s injury, but their medical history, occupation and lifestyle requirements.
Surgical Management of Ankle Instability
Surgery for ankle instability or severe ankle sprain first begins with an arthroscopic evaluation of the ankle. During this portion of the procedure, a small camera is inserted into the ankle joint and all of the damage in the joint is assessed and managed. Following arthroscopy, a small open incision is made to reconstruct the ligaments. If there is evidence of tendon damage or bony injury, these areas are similarly addressed during the open portion of the case.
The Road to Recovery
Postoperatively, a patient spends between 2 and 6 weeks non-weightbearing, depending on the extent of their repair. The patient then has 4–6 additional weeks of progressive weightbearing in a brace or a boot as they regain the strength in their leg. Physical therapy is crucial to a successful postoperative result. While the patient is usually fully weightbearing 6 to 8 weeks after surgery, full recovery often takes 6 to 12 months for a patient to reach their maximum benefit of surgery.
