Ankle Ligament Injury (lateral)

Patient Information

http://www.patient.co.uk/pdf/9192.pdf

https://www.bofas.org.uk/Patient-Information/Ankle-Instability

http://lateral-ligament-reconstruction-of-the-ankle.pdf

GP Information

Background Information

• Usually respond best to conservative management.
• Advise patients that ligaments may take longer to recover than fractures Patients typically present following trauma (ankle inversion) with pain distal to the lateral malleolus.

Investigation Guidelines

• Apply the Ottawa Ankle rules in order to determine of the patient requires an ankle XR.
• An USS is indicated in the setting of instability and diagnostic uncertainty.
• An MRI may help to grade severity and look for associated injuries.

Management Recommendations

The majority of ankle ligament injuries may be treated non-operatively with home exercises or physiotherapy Initial management includes;

• Prescribe PRICE in acute injuries.
• Avoid HARM for 72 hours following injury.
• OTC ankle support
• Avoid sporting activity until fully recovered.
• Physiotherapy referral after 6 weeks if symptoms have failed to settle

Referral Indications

• High level athlete may benefit from early repair.
• Diagnostic uncertainty
• Positive ottowa ankle criteria.
• Inability to bear weight.
• Need for physiotherapy.
• Inability to perform ADLs after 6 weeks
• Results of diagnostics indicate specialist assessment required.