Ankle Sprain(拗柴)

Ligament tear is an extremely common cause of ankle sprain during various work and sports activities or wearing improper footwear, such as wearing high heel shoes, walking on uneven surfaces, or misstepping while running or walking. Most ankle sprains are Inversion ankle sprains (±95%), eversion ankle sprains (±5%) are less common.

To determine the grade of your ankle sprain, look at the extent of bruising and swelling around the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL), and check for tenderness when pressing on them (as shown in the figure below). You can then choose how to treat the sprain based on these results.

Acute Ankle Sprains

Acute Ankle Sprains are classified into four grades based on the degree of tearing and dislocation of the (1) anterior talofibular ligament, (2) calcaneofibular ligament, and (3) posterior talofibular ligament.

Grade 1 Ligament Tear

Symptoms:

A moderate ATFL tear causes swelling and pain in the area or pain when pressed.

You can test this yourself by following the instructions in How to Self-Diagnose an Ankle Sprain 

Treatment :

Grade 2 Ligament Tear

Symptoms:

With a severe ATFL tear and a moderate CFL tear, you will experience swelling and pain in the area or pain when pressed. You can test this yourself by following the instructions in How to Self-Diagnose an Ankle Sprain 

Option 1: Option 2: Short Walker Boot A16b Ankle Brace(A09b)

 Wearing Ankle Brace (A09b), which has a cam-shell-like plastic plate on both medial & lateral ankle. Cinch devices are added to the plate to tighten the plate for ankle immobilisation, thereby accelerating ligament healing. This brace is able to wear a shoe and allows plantar flexion and dorsiflexion of the ankle, but prohibits varus and valgus movements.

Option 2: Short Walker Boot(A16b)

 A Short Walking Boot (A16b) with moulded aluminium stays on both medial and lateral sides to keep the ankle upright. Straps are added to the boot for tightening and stability of the ankle joint while walking.

Grade 3 Ligament Tear

Symptoms:

With severe tears of the ATFL and CFL, along with a moderate PTFL tear, there will be widespread swelling and pain, or pain when the area is pressed. You can test this yourself by following the instructions in How to Self-Diagnose an Ankle Sprain 

Grade 4 Ligament Tear

Symptoms:

Grade 4 ankle sprain is a severe case with ruptured ligaments and subluxation of the ankle joint. Symptoms are severe pain, swelling, instability and walking difficulty.

With severe tears of the ATFL and CFL, along with a moderate PTFL tear, there will be widespread swelling and pain, or pain when the area is pressed. You can test this yourself by following the instructions in How to Self-Diagnose an Ankle Sprain 

Treatment :

Option 1: Closed reduction+Cast+Short rigid Walker Boot(A16b)

After closed reduction, a cast is applied for 3 weeks, and X-ray is needed to ensure no residual subluxation. Crutches are needed to avoid weight-bearing, loading pain and loading-induced subluxation of the ankle joint. After that, the injured ankle can be further immobilised for another 3 weeks by a walker (A16b), and weight-bearing is progressively allowed with the help of crutches.

Option 2: Closed reduction+Long Rigid Walker boot(A17) +Short Rigid Walker boot(A16b)

If the patient does not want to undergo cast plastering, after closed reduction, a Long Rigid Walker Boot (A17) can be applied for 3 weeks, and an X-ray is needed to ensure no residual subluxation of the ankle joint. After that, the injured ankle can be further immobilised for another 3 weeks by applying a short walker boot (A16b). Partial weight-bearing is progressively allowed with the help of crutches.

Chronic Ankle Sprains

Chronic ankle sprains result from secondary injuries, ankle instability, or repeated sprains that cause the ligaments to become loose (laxity). Common symptoms include the ankle easily 'giving way' or rolling inward while walking, a lack of confidence in applying strength during sports, and swelling or soreness after being on your feet for a long time."

Treatment :

Stable Ankle Stabilizer(A08), Reinforced Ankle Brace(A03b) and Ankle Stabilizer(A05) use moulded medial and lateral plastic panels together with a figure “8” strap design to tighten and stabilize the ankle, and to prevent inversion motion. They support the injured ankle and strengthen the loosened ligaments, helping to prevent new sprains or recurrence of the old injury.