Lateral Ankle instability part two. It’s been a few months and you keep spraining your ankle, you have tried a brace and even a custom brace. Now you are very frustrated and want to know your options. First thing is get a thorough exam. Is there a positive anterior draw sign. Is there excessive inversion of the ankle. Where x rays taken to rule out stress fractures and osteochondral defects. There is a special X ray technique that we perform called the stress inversion x ray exam this exam is quite helpful in telling us if there are ankle ligament tears. Next is an MRI. MRI’s are very helpful in letting you know if there are tears, However it is my experience not to fully rely on MRI’s for they can be wrong many times. I have had many patients that have had severe instability with multiple sprains a week that had an MRI read as an intact ligament , but opted for surgery due to the major instability. What do you know, when I opened the area where the ligament was supposed to be there were none. Other things to be aware of are 2 conditions . One- torn peroneal tendons which can contribute to instability. It is important to repair torn peroneal tendons in order to maintain normal foot and ankle function. Also the position of your heel can contribute to ankle instability. It is called a varus positioned heel. If one has such a heel all the ligament repairs in the world won’t help because the stresses of the heel will re tear the ligaments. In those unique cases the heel bone needs to be re aligned into a proper position in order to obtain proper function. I have seen too many cases of ligament repairs gone bad because of other issues that were not identified .
this is a letter from a patient of mine that had sustained a ligament tear while on the job fighting fires. ” Dear Dr Wrotslavsky Thank you for fixing my ankle . After I tore my ankle ligaments I thought my career as a firefighter was over. I needed my ankles to work in order to go down steep slopes while fighting fires. I was also so worried because I loved to play basketball on the weekend and I could not after the ankle ligament tear. Thank you for Taking the time to carefully look over my MRI and explain everything in depth what was needed to be done surgically to fix it. I now have a very stable ankle for over a year and have not felt any pain and I am able to perform my job as a firefighter. and I can also play ball on the weekends. Thank you Dr Wrotslavsky S.B. San Diego California
Lateral Ankle instability part two
below is a picture of a ankle ligament repair due to Lateral ankle instability along with a peroneal tendon repair using the internal brace technique