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Ankle ligament injury: causes, symptoms, diagnosis, treatment
Last reviewed: 04.07.2025
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ICD-10 code
S93.2. Rupture of ligaments at ankle and foot level.
What causes ankle ligament damage?
Among isolated ruptures of the ankle joint ligaments, only a violation of the integrity of the anterior talofibular ligament is practically encountered. The mechanism of injury is indirect - forced supination with plantar flexion.
Symptoms of ankle ligament injury
Patients are bothered by sharp pains in the ankle joint, which significantly limit its functions.
Where does it hurt?
Diagnosis of ankle ligament injury
Anamnesis
The anamnesis indicates trauma.
Inspection and physical examination
The joint and the back of the outer surface of the foot are swollen. On the 2nd-3rd day after the injury, an extensive bruise appears here. Palpation reveals pain along the anterolateral surface of the ankle joint and foot, and the intensity of the pain increases if palpation is performed with simultaneous slight plantar flexion and adduction of the foot. Active and passive movements in the joint are sharply limited due to pain. After anesthesia, excessive deviation of the foot inward and to the plantar side is revealed. Pressure on the calcaneus upward (axial load) does not cause pain.
Patients limp, rotate the limb outward when walking, leaning only on the heel. Tight bandaging of the joint reduces pain and makes it easier to use the limb.
Laboratory and instrumental studies
Radiographs may reveal a rupture of the cortical layer at the site of ligament attachment.
What do need to examine?
How to examine?
Treatment of ankle ligament injuries
Conservative treatment of ankle ligament injuries
In recent cases, conservative treatment of ankle ligament damage is used. After a procaine blockade of the damaged area (1% solution, 10-15 ml), a circular plaster cast is applied from the upper third of the shin to the tips of the toes. The foot is deflected at an angle of 90° and rotated outward (hypercorrection, valgus). The immobilization period is 6 weeks. Then, restorative treatment is indicated. For 1-2 months, the joint is fixed with a figure-8 gauze bandage.
Surgical treatment of ankle ligament damage
In case of old ruptures, ligament plastic surgery is most often performed using the Watson-Jones method. The material used is the tendon of the short peroneal muscle. The immobilization period is 2 months. Postoperative treatment of ankle ligament damage is the same as with the conservative method.
Approximate period of incapacity
In recent cases, working capacity is restored within 2-2.5 months.
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