lateral ligament injury
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Lateral ligament injury
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Clinical featuresA history of a twisting injury followed by pain
and swelling
If the patient is able to walk, and bruising is only
faint and slow to appear, it is probably a sprain
if bruising is marked and the patient unable toput any weight on the foot, this suggests a moresevere injury.
Tenderness is maimal just distal and slightly
anterior to the lateral malleolus. The slightest attempt at passive inversion of
the ankle is etremely painful.
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Imaging
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Treatment!IC" therapy for #$% weeksCold compress for &'mins(&hrs
)!IC" therapy
*+AI-s*+AI gels or creams
)rotected mobility
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perative treatment)ersistent problems at #& weeks after
injury may signal the need for operativetreatment.
!esidual complaints of ankle pain andsti/ness, a sensation of instability or givingway and intermittent swelling aresuggestive of cartilage damage orimpinging scar tissue within the ankle
Arthroscopic repair carried out in suchcases
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!ecurrent lateral instability The patient gives a history of a 0sprained
ankle- that never 1uite seems to recoverand is followed by recurrent 0giving way-
The ankle looks normal and passivemovements are full
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Anterior drawer test
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Talar tilt test
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Treatmentmodifying shoe$wear, raising the outer side
of the heel
)eroneal strengthening
Arthroscopic repair of lateral ligament2ould or brostrom karlsson operation
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2ould operation
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In the second type of operation a substituteligament is constructed by using peroneusbrevis
)ostoperatively the ankle is immobili3ed ineversion for & weeks4 a below$knee cast isthen applied for another 5 weeks
After that a removable brace is worn andeercises are encouraged.
The brace can usually be discarded after %months