Ankle Instability is a condition that occurs when the outer ligaments that support the ankle joint are injured or damaged. The condition can be either mechanical or functional. In case of mechanical instability, the ligaments become loose resulting in laxity. However, in functional instability, the ankle joint is anatomically stable but the patient has a constant feeling of joint weakness.
The ligaments that get affected in this condition are the anterior talofibular ligament and the calcaneo fibular ligament.
Causes
- Ligament tear, stretch or rupture
- Repeated episodes of ankle sprain
- Arthritis of ankle joint
- Damage to nerves that surround the ankle
- Osteochondral lesions that develop in the talus and thus damage the joint cartilage
- Conditions like Flat Foot or Hindfoot Varus Alignment
- Presence of loose ligaments in the ankle
- Sports activities that involve a lot of jumping and high impact movement
- Bone spurs may impinge upon the ligament
- Bone fractures in leg or foot
- Inflammation of synovium lining within the joint
Symptoms
- Bruising
- Inability to bear bodyweight on the ankle and foot joint
- Constant pain on the outer part of inside the ankle
- A constant feeling of the ankle rolling outwards whenever moved
- Swelling and stiffness
- Change in gait and development of a limp
- Hypermobility of the joint
Diagnosis
- Analysis of the symptoms and medical history
- Weight-bearing
- X-ray imaging
- MRI and CT scans may be required
- Fluoroscopy
- The exact location of pain may be assessed through palpation
Treatment
Conservative treatment methods include the following:
- Wearing an ankle brace for joint support
- Painkillers and anti-inflammatory medicines may be prescribed
- All physical movements that stress the joint need to be avoided for some time
- Physical therapy may help to improve joint function and strength
- Compression of the joint using a soft bandage is necessary
- Use proper footwear and shoe inserts that help support the joint
- Ankle splinting and taping may be helpful
- Ankle Proprioception – Special therapy that improves brain and ankle coordination
- Steroids may be injected directly into the joint
Surgical methods of treatment include the following:
- Brostrom Procedure – Surgical tightening or shortening of the injured ligaments.
- Replacement of the damaged tissue using donor tissue which may have been extracted from a body part or artificially synthesized
- Calcaneal Osteotomy helps to realign the hindfoot by cutting the heel bone and fixing it in correct alignment using screws
