About Orthopaedic Surgery

Ankle

Ankle Anatomy | Ankle Sprains

Ankle Anatomy
The ankle is a joint in which the talus (ankle bone) moves in the concavity made up of the tibia and the fibula (leg bones). The talus flexes and extends within the joint, with side-to-side motion controlled by the lateral and medial ankle ligaments (on the outside and inside of the joint, respectively). top

Ankle Sprains
The most common injury to the lower extremity is to the ankle ligaments. The ligaments on the lateral, or outside, side of the ankle are injured when the foot is twisted under the tibia, (leg bone), when the foot is placed on an uneven surface, such as landing in a hole.
The first injury is to the ligament between the ankle bone and the leg bone (anterior talo-fibular ligament). Additional force will injure the ligament between the heel bone and the ankle bone (calcaneal-fibular ligament). Initial signs are swelling and tenderness over the lateral side of the ankle. If the ankle has been repeatedly injured, there may be less swelling and pain and the x-ray may show laxity of the ligaments if stress is applied.

Treatment of lateral ankle sprains should initially include rest, ice, compression and elevation. X-rays should be done if bony tenderness is present. Crutches, and even splinting, may be needed to control pain. As soon as pain allows, early, protected, motion should be started in a functional brace, such as an air cast, which allows flexion and extension but protects the ankle from side to side motion; weight bearing on the injured foot can then start. If competitive sports or other strenuous activities are contemplated, the ankle should be rehabilitated adequately, with satisfactory motion and good muscle control present before return to these activities. This will require muscle re-education so that the ankle is able to withstand one-legged stance, hopping, jumping, and rapid change of direction while running. An air cast or similar brace may be used when these activities are resumed to minimize the chance of re-injury.

If the ankle has been repeatedly sprained, there may be chronic laxity of the ankle ligaments, resulting in frequent episodes of instability of the ankle, particularly when walking or running on uneven ground, and in increasing frequency of injury. This condition may require surgical reconstruction, either by substitution for the injured ligaments by using the ankle tendons, or by using a portion of the adjacent ankle ligaments. top

NOTE: The information on this site is informational only and is not intended to be medical advice. NO ANSWERS TO MEDICAL QUESTIONS WILL BE GIVEN BY E-MAIL OR OTHER CORRESPONDENCE. Contact your physician for advice about specific medical conditions.

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