Foot & Ankle

Ankle Instability

What is ankle instability?

Ankle instability is a condition in which the ankle joint is prone to repeated sprains or rolling, leading to chronic pain, swelling, and weakness. The condition is often caused by an injury to the ankle, such as an ankle sprain, that has not healed properly and has weakened the ligaments that support the ankle joint.

The ankle joint is supported by several ligaments, including the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). The ATFL runs across the front of the ankle joint from the fibula bone the talus bone. The CFL runs down the side of the ankle joint from the heel bone to the tip of the fibula. These ligaments play a critical role in stabilizing the ankle joint and preventing excessive movement.

When the ankle is injured, such as in a sprain, the ATFL and CFL ligaments can become stretched or torn. This can weaken the ankle joint and make it more susceptible to further injury or instability.

Symptoms of ATFL and CFL tears may include:

  • Pain and tenderness on the outside of the ankle
  • Swelling and bruising around the ankle joint
  • Difficulty bearing weight on the affected ankle
  • A feeling of instability or giving way in the ankle joint
  • Limited range of motion in the ankle joint

The main treatment for ATFL and CFL tears is non operative. This involves rest, ice, compression and elevation (RICE) during after then initial injury. After the pain settles a rehabilitation program involving strengthening, movement and balance helps to regain ankle function. If the injury keeps happening, or if it doesn’t get better despite a very good rehabilitation program, surgery may be necessary to repair or reconstruct the damaged ligaments.

The specific treatment plan for ATFL and CFL tears will depend on the individual case. Prompt treatment and rehabilitation can help to restore strength and stability to the ankle joint and reduce the risk of further injury or instability.

What is an ankle stabilisation?

Ankle stabilization is a surgical procedure that aims to restore stability to the ankle joint by repairing or reconstructing the damaged ligaments. The procedure is typically recommended for individuals with chronic ankle instability that has not improved with non-surgical treatments, such as physical therapy and bracing.

One common ankle stabilization procedure is based on the Brostrum procedure, named after the surgeon who first described the technique. Contemporary surgical management involves assessing the ankle joint and attending to any damage with an arthroscope, repairing or tightening the damaged anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL). During the procedure, the surgeon makes a small incision on the outside of the ankle and exposes the damaged ligaments. The ligaments are then shortened and reattached to the fibula bone using stitches or anchors.

There are a variety of other ankle stabilization procedures for special situations. Special procedures may be used when there has been a lot of surgery beforehand, or if a patient has easily dislocating joints.

After ankle stabilization surgery, patients will need to wear a cast or brace while the wound heals. Physical therapy is recommended to help regain strength and mobility in the ankle joint. The specific recovery time and treatment plan will depend on the individual cases.