In the past decade, ankle injuries have been one of the areas where treatment approaches have changed the most. The ankle joint is formed by the main surface of the tibia on the outside, which is supported by the socket formed by the fibula, and the talus bone. The factor that complicates the structure of this joint and its treatment in accidents is the presence of 4 ligaments on the inside, 3 on the outside, and 1 syndesmosis ligament that connects the tibia and fibula at the top. The multiple ligament structures provide controlled movement and ensure the smooth functioning of the joint.

Ankle Sprains After an ankle sprain, the following symptoms may occur in the ankle:

  • Pain
  • Swelling
  • Redness, followed by bruising after a few days
  • Tenderness when touched
  • Pain and difficulty bearing weight

If any of these symptoms are present, even if they are not severe, it is important to see a doctor.

Most ankle injuries can be adequately evaluated with a simple X-ray in addition to a good examination. Rarely, a CT scan or MRI may be necessary.

Treatment

The most common injury is a tear in the outer ligaments. Except for very mild injuries (grade I), most of them require a cast. In cases where a cast is not applied, the ligaments cannot heal in their full form, leading to recurrent ankle sprains. A circular motion is added to the ankle’s physiological back-and-forth movement, which can lead to joint calcification over time. Nowadays, due to plaster technologies that can be easily walked on, bathed in, and worn with shoes, taking risks is extremely senseless. The duration of the cast depends on the severity of the injury and is usually 3-6 weeks. In severe cases, surgery may be necessary.

Internal ligament tears are rare and most require surgical intervention. Otherwise, the ligament cannot heal, and a grinding motion similar to that of an external ligament tear develops, resulting in serious calcification within a short period (1-3 years).

The outer part of the ankle joint on the fibula is called the lateral malleolus. If it is fractured alone and not displaced, a 6-week cast is sufficient. If lateral malleolus fractures are accompanied by an internal ligament tear, a brief dislocation may occur, and surgery is always necessary, even if the dislocation appears to be reduced on X-rays.

The bony protrusion that forms the inner support of the tibia’s joint is called the medial malleolus. Most of these fractures require surgery.

Problems related to untreated ligament injuries may require reconstruction surgery.