re-constructive surgery on ankle

[gyaradoz]

Dear all,

I have ruptured a ligament in my right ankle(RTF I think) and torn a ligament in my right ankle..

I have already made an appointment to go for surgery, re-constructive surgery..

Actually, I can move around and run with ease.. I have heard from friends that after the op my right ankle will be very stiff and very difficult to recover.. He added that he had a friend who went for similar surgery and after 4 months still had difficulty just walking!!!

Do you all think I should go for the surgery? Will my right ankle be agile and flexible again(up to 100 percent maybe?) after the surgery? Or will I end up with a permanent stiff ankle forever?

Please assist.. Thanks

Regards
gyaradoz

[injuryupdate]

Sounds like you should put off the surgery. Ankle ligament injuries are very good at healing themselves. 90-95% don't need surgery. They are actually more likely to require surgery to relieve stiffness than reconstructive surgery to relieve instability. A reconstruction can improve your stability but at a cost of stiffness. The only reason you should have the reconstruction is if your ankle is currently unstable (i.e. it collapses or gives way on you when you try to change direction, despite using a tape or brace). It sounds like the risk of stiffness from surgery (plus cost and general risks like DVT, infection) would outweigh the benefits (which sound minimal given you can run with ease) in your case.

[gyaradoz]

Dear Injuryupdate,

I actually have all the time to recover from the Operation because I am currently a soldier, serving National Service... I still have 9 months to my ORD(Operational-Ready Date).. i.e. to my freedom..

I will not mind staying at home for months , and I prefer that than to go for that stupid army..Some more I do not need to pay for the Operation as I have injured myself in camp..

What I am more concerned of is that my ankle is not as agile as before and be very stiff.. As time goes by, will my ankle heel? Will it be as agile and flexible as before?

Please assist.. Thank You..

[Unregistered]

could you tell me please what fashiotomy is

[mcculloughfloss]

gyaradoz, a year ago, i was playing tennis and rolled my left ankle inwards (which is how most ankle injuries occur). well I couldnt put any weight on it for about 2 weeks and I had the fattest foot I have ever seen an it was green. I had bruising up the back of my calf for over a month. Apparently I tore all of the ligaments in that ankle. At the moment, I dont have pain while playing netball and tennis (I have it taped and wear an ankle brace). Little things hurt though, crossing my legs etc and I have little range of movement and its still very stiff to bend backwards and point etc. The doctor has referred me to an orthopaedic surgeon so I can get an MRI on it and he suggested maybe an operation to repair the ligaments (I think he said they are tight and need to be loosened). Has anyone had this operation and how did it go?? I really want it done, coz at the moment, my ankle is only about 80% after a year!!

[Dr Expert]

I don't think you should. I agree with the Injury Update Administrator, ankle ligament injuries can heal alone.

[Unregistered22]

Hi,

I have suffered from severe ankle sprains / tearing of ligaments for 5 years now. In those 5 years I have suffered 2 bad sprains and 2 third-degree spains, on one occasion I thought my ankle was broken as the swelling was unbelievable. After plenty of physio and exercising my ankle was still not strong and was very prone to the same injury reoccurring. I would sometimes go over on it whilst jogging without causing bad damage. The fact that I continued going over on it suggested that there was still a problem with it.

Although the ankle didnt really cause any pain day-to-day when it wasnt injured it did make a horrible clicking noise whenever I moved it. Again this told me that all was not right.

I decided to go and see another doctor (not my normal general practioner as he just always told me to exercise the ankle and go to physio). This another doctor referred me to an orthopedic consultant. The consultant had a play around with my ankle and also made me have some MRI scans on the ankle. The results showed him that I needed surgery - keyhole surgery and also an ankle ligament reconstruction (bostrum procedure is the actual surgery type i had). The consultant was a sports surgeon who had recently removed a cyst from my friends knee with success so i trusted his word!

I went ahead and had this surgery done last Tuesday (11th) and am therefore still recovering. The rehabilition involves: 10 days in a cast and then a further 5 weeks in a walker Aircast boot. After this I believe I will also be given a special brace to wear inside my shoe for a further 4 weeks.

I had my cast removed 2 days ago so now have to wear this removable Aircast for 5 weeks. Although I can take it off for washing and for slowly exercising the ankle I must wear it at all times when walking and even when i go to bed!

The ankle is very stiff at the moment and does hurt when I move it round but since I have been able to start exercsing it 2 days ago I have noticed the stiffness and pain has been getting slightly better. It does hurt when I walk in the boot and place pressure on the ankle but this of course is natural as it hasnt been 2 weeks yet. I am still therefore using crutches to help me but expect to be able to walk without crutches at some point in the next week.

My advice would be to maybe stay away from surgery until you know there is definately a problem which will re-occur in the futute. Ankle sprains are a common injury but many people will sprain an ankle and then fully recover without any problems. Other like myself will always have a re-occuring problem on the ankle, particularly if the first sprain is not properly repairing. Try and get physio on your recent sprain or if not try and exercise your ankle and build up the strength in it. If after rehab you sprain the same ankle again then it is time to consider surgery.

A useful thing to do for recovering ankle sprains is the 'Hot water Cold Water' treatment. This is where you have a bucket of cold water and a bucket of hot water. Dip in injured foot/ankle into the bucket of cold water for 30 seconds and then remove it and immediately put your foot in hot water for 30 seconds. Continue changing for 5-10 minutes. This gets the blood circulating fast around the ankle and will help the ligaments repair themselves quickly. Once my wounds have healed up I will be definately be doing this as often as possible.

I hope this helps
Andy.

[mcculloughfloss]

wow, that explained heaps. But, after i did this ankle over a year ago, it is still weak and feels like I will roll it if i dont wear my ankle brace. Its still ft from scar tissue swelling etc, but i havent rolled it and sprained it since. I just dont think it should still be this stiff after so long. can u please keep updating me with how your ankle recovery goes? that was a grea read, thanks andy.

[Cameron]

Hi

I wouldnt get the surgery as your ligaments will heel and you can do alot of strengthing work to help support the ankle.
I have torn 3 of my major ligaments in my ankle about 5 years ago playing rugby. It took me about two years to get back on the feild and i still wasn't 100% my akle still roled and gave way on me and still does today ocasionally, but 95% of the time i don't feel any pain or have any problems, most physios will tell you not to get the surgery unless you are a professinal athlete and it is you way of making a living, otherwise do the proper rehab and strengthing work and you will be suprised.
The tightness and stiffness your ankle will aventually pass but it does take time you just have to patient with it.
I am now looking at getting my ankle reconstructed only because i snowboard alot and the pressure of jumping and twisting your legs in weid ways is getting to much on it but it still doesnt give me any trouble playing rugby.
If you have 9 months to sit and do nothing that is heaps time to get your ankle pretty good with out surgery but i will take a fair bit longer to get as strong as it was but you will.

[andy99]

wow, that explained heaps. But, after i did this ankle over a year ago, it is still weak and feels like I will roll it if i dont wear my ankle brace. Its still ft from scar tissue swelling etc, but i havent rolled it and sprained it since. I just dont think it should still be this stiff after so long. can u please keep updating me with how your ankle recovery goes? that was a grea read, thanks andy.


I'm glad you found it helpful. it took long enough to type it up!! :)

its now been almost 6 weeks post-op and I'm feeling ok. the ankle is pretty mobile although I am still wearing the aircast boot as I have to wear this until Tuesday. I have been allowed to remove it when sitting down watching TV, and can slowly exercise it, which bit by bit has really helped in the rehab of it. Pain is quite minimal. I've been doing quite a bit of walking around to shops etc and its generally been fine. there is still swelling but this is normal.

Tuesday I go back to see the consultant which is when I hopefully get the thumbs up to remove the aircast boot and finally walk unassisted (although I think I have to wear some sort of brace/support for a further 6 weeks). generally though I'm quite pleased with the progress and hope that once I start physio my ankle will start to feel normal for the first time since July 2001!

Cameron makes the point that ligaments do heal which is true but they won't always heal back like they were originally e.g. once you torn a ligament and stretched it, it will heal but the fact that it has been stretched will always give the ankle a slight weakness over how it was originally.

Again, only consider surgery once none of the other options (physio and strength building) have worked.

will keep you updated on my progress! :)

cheers

[kjwilkin]

Hi there,

In most cases people will recover from an ankle sprain with the right rehab program.

However, there are still a small group of people that don't respond to conservative treatment. Unfortunately I fell into that category and underwent an ankle reconstruction at the end of January. It has helped me heaps and my ankle is really stable now.

Am still building up on my exercise, but am gradually getting there after about 7 months. I've been told it could take up to a year.

Good luck !

[Pranav]

Hi !
I read through the discussion board, and felt i could advise on something for good of all of us.
Ligaments unlike muscles heal slow, as they are rigid and lack in blood supply. This little blood supply slows up the healing unlike muscles.
But hopefully there are ways to increase this blood supply...
1). Mild exercise and movement of the soft tissues.
2). Visit a Steam bath, Sauna as often to increase general blood flow.
3). Apply heat packs over the ligaments 2-3 times a day.
4). Proteolytic enzymes like Papain, Trypsin, bromalaein are natural analgesics, which thin the blood naturally so the blood flow increases. The action is like any pain killer like aspirin or neurofen, but they instead also delay the healing process of the body. These enzymes can be obtained from pharmacies, and also fruits like Papaya and Pineapple are rich in Papain and bromalaein.
I hope this all information helps you !
Pranav

[kjwilkin]

You need to be careful in the advice you are giving.

Heat should not be used while you have swelling as it can actually make it worse. Ice should be used whilst there is swelling. I know this from being a sports trainer and the training I have done.