Ankle Ligament Injury (lateral)

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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.