Ligamentous Injury of the Ankle
Abd Elaziz Abd Elfattah Elbarky;
Abstract
Ligamenteous injury of the Ankle joint is one of the commonest injuries in athletes. Stability of the ankle joint depends mainly upon three factors, which are :
• Bony architecture.
• Ligaments.
• And capsule of the joint.
The ankle joint is formed by articulation between the talus and the tibia, talus and fibula and tibia and fibula. The ligaments of the ankle joint are the medial and lateral ligaments and the syndesmotic ligaments.
The capsule of the joint surrounds it form all the directions.
Biomechanics of the ankle joint is unique and it is important to understand factors affecting ankle stability as the axis of the joint changes with the movement of the ankle from dorsiflexion to planterflexion besides the subtalar joint is moving in a different direction that allows the eversion and inversion during walking on an uneven ground. Ligaments of the ankle move with the movement of the ankle to make real collateral ligaments all through the range of movement of the ankle.
Diagnosis of ligamentous injury of the ankle depends mainly upon:
1- History taking.
2- Clinical examination of the ankle.
3- Radiographic examination.History is important do detect the nature of the injury and any other diseases.
Clinical examination depends upon detection of the site of maximum tenderness and special tests like eversion, inversion stress tests external rotation test and anterior drawer test.
Examination by x-ray is one of the most essential methods of diagnosis as there are three major positions for examinations, which are the anteroposterior view, lateral view and 15-20º internal rotation view (Mortis view).
Arthrographic examination of the ankle is helpful but with lots of false results as well as it should be performed within 48 hours.
MRI of the ankle is one of the most recent and most accurate methods of diagnosis of the ligamenteous injuries.
Many classifications of the ankle ligamenteous injuries was done like Leech classification, 1983, Griend, 1991 classification. Wolf 2001 classified the ligamenteous injuries of the ankle into three groups depending on the severity of tenderness, functional loss and mechanical instability.
Treatment of the ankle instability due to ligamenteous injuries is conterversal. Some authors recommended the conservative treatment in the form of PRICE (Protection, Rest, Ice, Compression and Elevation)
• Bony architecture.
• Ligaments.
• And capsule of the joint.
The ankle joint is formed by articulation between the talus and the tibia, talus and fibula and tibia and fibula. The ligaments of the ankle joint are the medial and lateral ligaments and the syndesmotic ligaments.
The capsule of the joint surrounds it form all the directions.
Biomechanics of the ankle joint is unique and it is important to understand factors affecting ankle stability as the axis of the joint changes with the movement of the ankle from dorsiflexion to planterflexion besides the subtalar joint is moving in a different direction that allows the eversion and inversion during walking on an uneven ground. Ligaments of the ankle move with the movement of the ankle to make real collateral ligaments all through the range of movement of the ankle.
Diagnosis of ligamentous injury of the ankle depends mainly upon:
1- History taking.
2- Clinical examination of the ankle.
3- Radiographic examination.History is important do detect the nature of the injury and any other diseases.
Clinical examination depends upon detection of the site of maximum tenderness and special tests like eversion, inversion stress tests external rotation test and anterior drawer test.
Examination by x-ray is one of the most essential methods of diagnosis as there are three major positions for examinations, which are the anteroposterior view, lateral view and 15-20º internal rotation view (Mortis view).
Arthrographic examination of the ankle is helpful but with lots of false results as well as it should be performed within 48 hours.
MRI of the ankle is one of the most recent and most accurate methods of diagnosis of the ligamenteous injuries.
Many classifications of the ankle ligamenteous injuries was done like Leech classification, 1983, Griend, 1991 classification. Wolf 2001 classified the ligamenteous injuries of the ankle into three groups depending on the severity of tenderness, functional loss and mechanical instability.
Treatment of the ankle instability due to ligamenteous injuries is conterversal. Some authors recommended the conservative treatment in the form of PRICE (Protection, Rest, Ice, Compression and Elevation)
Other data
| Title | Ligamentous Injury of the Ankle | Other Titles | تهتك الأربطة حول مفصل الكاحل | Authors | Abd Elaziz Abd Elfattah Elbarky | Issue Date | 2014 |
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