Ankle Ligament Injuries / Ankle Sprains

Ankle sprains and injuries of the ankle are some of the most common musculoskeletal injuries physicians treat. Most ankle sprains will resolve and patients will improve without the need for further intervention. After recurrent ankle sprains, or after a severe ankle sprain, long-standing pain or instability in the ankle may develop. After a period of 3 to 6 months following a standard ankle sprain, continued pain or instability of the ankle is unusual, particularly after undergoing an appropriate course of physical therapy and other conservative interventions. In this scenario, treatment with an orthopaedic foot and ankle specialist is indicated.

Instability is the continued lack of confidence, recurrent sprains, or feeling of giving way of the ankle that becomes a long-standing problem. This may occur during sporting activities but may also occur and is particularly concerning if occurs during every day activities, such as walking on uneven surfaces or without any specific trauma. For those that have failed conservative treatment, a reconstructive procedure to reconstruct the ankle ligaments by tightening back to the bone may be necessary. Some of the surrounding tissues are often used to reinforce the repair strongly. The majority of patients simply need this type of procedure to improve their symptoms. In some patients with poor or severely stretched out ligaments which are not repairable, other tissue is necessary to reconstruct the ligaments of the ankle. Sometimes additional bone correction is necessary for patients with abnormal bone alignment of the heel. The procedure involves non-weight bearing for 6 weeks followed by 6 weeks of protected weight-bearing in a cast and at 12 weeks transition to regular shoes is possible. Return to sport is individualized based upon level and type of activity but can generally be expected to occur around 4 to 6 months after surgery.

Another problem that can occur is continued pain in the ankle or surrounding tissues after recurrent ankle sprains or instability. For such patients additional evaluation of the ankle for problems involving tendons around the ankle (peroneal tendons), ankle joint lining (soft tissue scar impingement of the ankle), cartilage lining of the ankle joint for possible chip fracture (osteochondral lesion), or other problems requires evaluation. Many of these problems require surgical intervention to improve symptoms and to prevent progression of pain.

Dr. Vora specializes in the treatment of sports related injuries of the foot and ankle and utilizes arthroscopic or minimally invasive techniques whenever possible for such conditions to minimize recoveries and maximize outcomes whenever possible. Dr. Vora has published and lectured on these conditions both locally and nationally and instructs other orthopaedic surgeons in the treatment of these conditions.