09 Jul Signs That a Sprained Ankle Might Require Surgery
Athletes and active Americans will know the typical history of a sprained ankle. You land on it funnily and roll the foot resulting in swelling and pain. For a time maybe you think it’s broken but slowly the swelling subsides and you forget all about it. But occasionally a sprain can actually need surgical repair. Here’s how to know if that’s the case.
What is a sprained ankle?
The muscles around your ankle can be injured in a number of ways including a contusion, a sprain, and a laceration. A contusion occurs when a sudden compressive force like a direct blow to the muscle occurs. This is common in contact sports like football or hockey.
Strains, however, are far more common in sprinting and jumping and occur when the myofibers that make up the muscle are overstretched and rupture at the junction of the muscle and the tendon.
A sprain, however, is an injury that occurs to the ligaments surrounding a joint.
How do I know if it needs surgery?
If you have a grade 3 sprain or strain – you might be a candidate for surgery. Sprains are often graded 1-3 depending on their severity (grade 3 being worst).
- Grade 1 is defined as mild damage to individual muscle fibers that don’t cause much loss of strength or of motion.
- Grade 2 is defined as extensive myofiber damage but not complete rupture of the muscle.
- Grade 3 is defined as complete rupture of the muscle or tendon.
There are a number of features that suggest an individual has a grade 3 sprain. These include:
- Severe bruising in the location of the injury
- The pain is significantly out of proportion to the injury
- There is a significant impairment of function (ie not able to walk at all)
- There is severe local tenderness of the sprain
- The X-ray shows there is no fracture
- There is significant swelling
According to current research around 90% of patients will have some of these signs. Patients with a grade 1 strain should be ok to walk around and this sort of injury often heals on its own in a week or two. A larger, grade 2 sprain, however, can cause significant swelling and heals in a few months. People with a grade 3 sprain should get in contact with a specialist clinic within a week of the injury to discuss the possibility of surgery. Whilst many advocates for conservative treatment without surgery this is decided on a case by case basis with the surgeon. Usually, the surgery is completed within a week of the injury but should be delayed until 24 hours after. This is done because intense swelling can severely hinder recovery.
It can be difficult to know for sure whether a sprain is mild or serious so it’s important to get in contact with specialists if you are at all concerned.