Reconstructive Foot & Ankle Surgery

Ligaments are the fibrous connective tissue that connects the bones together in joints. Ligaments stretch in their limits allowing us to perform various activities such as bending and turning without hurting ourselves. However with forced stretch beyond their limits ligaments may tear. Ankle ligament tear is a common injury with more possibility in sports personalities.

Ligament tear, commonly called as sprain is common in ankle joint and may be caused while playing sports, physical activities or even during normal activities such as stepping down the stairs. Ankle joint has two sets of ligaments, lateral collateral ligaments and medial collateral ligaments.

The lateral collateral ligaments include

  • Anterior talofibular ligament
  • Calcaneofibular ligament
  • Talocalcaneal ligament
  • Posterior talocalcaneal ligament
  • Posterior talofibular ligament

The medial collateral ligaments include

  • Tibionavicular ligament
  • Calcaneotibial ligament
  • Anterior talotibial ligament
  • Posterior talotibial ligament

Anterior talofibular ligament is the most commonly injured ligament. Ligament tear is graded on a scale of 1–3 based on severity of tear. Tenderness, pain and swelling are the common symptoms and grade 2 as well as grade 3 tears may be associated with decreased range of motion and instability of joint. Grade 1 and 2 tears may be treated by weight bearing exercises, motion and stretching exercises, isometric exercises, and immobilization. Grade 3 tears may require ligament reconstruction.

Reconstruction procedure is recommended if the rehabilitation programs are not successful and if a patient remains symptomatically unstable with loose ligaments or with stable ligaments but failure in ankle improvement. Your surgeon checks the ligaments for laxity and then proceeds to reconstruction where an incision is made so as to expose lateral capsular structures and ligaments. Then the capsule is opened and the anterior talofibular ligament is divided. Multiple sutures are used to tighten the capsule and ligaments. Your surgeon may also use the other ligaments or tendons in the foot to repair the damaged ligament. Then the wound will be closed using absorbable sutures. Following the surgery, you will be advised to practice certain strengthening and motion exercises for better and quicker recovery. Ligaments tear if not treated may pose the risk of developing arthritis.