Ankle sprains are a very frequent injury in sports, but also in children’s games, social and working life. Ankle ligament injury has always been considered a benign injury and treated with conservative methods.
However, in up to 40% of cases, the ligament injury does not heal properly and leaves significant sequelae. This situation, which is known as “the badly healed sprain”, shows that the initial sprain has not healed correctly because it was really a more complex injury that required more specific treatment.
Partial or complete ligament injuries are usually accompanied by internal injuries that may go unnoticed on initial physical examination. Thanks to arthroscopy, they can be explored, detected and adequately treated.
Previously, even with complex studies, injuries of the external ligaments of the ankle were reported, but they were considered minor injuries and conservative treatments were the appropriate and recommended “modus operandi”.
Joint laxity
However, arthroscopic examinations of ankles presenting “a badly healed sprain” demonstrate alterations within the joint due to the weakening of the injured ligament itself, which “does not bind” the bones as before and therefore a certain state of joint laxity is created. In addition, the cartilage, the capsule, the other ligaments… are modified and altered according to each patient and his clinical and functional situation.
The consequences of ligament laxity are technically known as ankle impingement syndrome. Fretting syndrome may be due to soft tissue entrapment or to deformities and alterations of the bone itself.
Arthroscopy allows us to repair ligament injuries by performing a direct ligament repair or a replacement plasty of the altered ligaments, but it also allows us to treat the consequences in the form of associated lesions in the cartilage or other structures of the ankle joint. Sometimes, in the same arthroscopy, the causes and consequences can be treated at the same time with a form of surgery that is certainly less aggressive and with a faster recovery.