Dr. Gold's Orthopedic Surgery Blog

Before proceeding with ankle surgery, I think it’s very important for patients to understand the anatomy and the diagnosis of a very severe sprain. That said, here is some information for you to consider….

The ankle is a complex joint consisting of three bones, which are the tibia, the fibula and the talus. Tendons connect these bones to the muscles, and ligaments connect the various bones. A sprain is an injury to one or more of these ligaments. A sprain is not the same as a strain, which involves the muscles instead of the ligaments.

An ankle sprain can result from playing contact sports or simply walking on unstable ground. During the 1970s, extreme platform shoes were credited with numerous ankle injuries. Even as simple an act as standing can cause an ankle sprain if the foot is placed incorrectly or is unstable.

Ligaments are somewhat elastic, and under normal conditions, they stretch to accommodate movement before returning to place

. If a movement or trauma exerts too much force on the ligament, it may be torn. The tear may be complete or partial, resulting in pain and instability. If the ligament is not completely detached, it may become elongated, making the patient feel unsteady on his feet or generate pain.

Physicians grade ankle sprains from one to three, with a grade 3 being the most severe. A patient with a sprain of this severity will experience a significantly swollen ankle with tenderness and instability. A grade 3 sprain is treated without surgery by casting or bracing the joint to immobilize it for two or three weeks.

If the sprain does not respond to rest, therapy and medications, or if the instability persists for several months even with conventional treatment, ankle surgery may be an option. In addition to X-rays and MRIs, the doctor may perform an arthroscopy to take a closer look at the joint to determine whether the ligament is being pinched or if there might be loose pieces of cartilage or bone.

Depending on what the examination shows, the surgeon can often make repairs with a minimally invasive procedure. Ligaments can be repaired with sutures, or a graft may be taken from another ligament or tendon to patch the tear.

Recovering from ankle sprain surgery will depend on numerous factors, including the severity of the injury and the therapy the patient receives. At best, recovery will take several weeks, and it is not uncommon for rehabilitation to last for months. A complete return to stressful or high-impact activities can take up to a year, although some patients may find they will never be able to resume such strenuous activities.

I hope this better helps you understand the reasons you may need surgery for a sprained ankle.

Until next time,
Stuart

I was recently asked to discuss orthopedic surgery on The Home Show Radio Show near my office in Torrance, Southern California. To listen to the second part of the recording, simply press the play button below.

Host: And welcome back to the Home Show here on News Talk 870 KRLA. My name is Jessie Lovelady, as if you don’t know it already, and I’m with Dr. Stuart Gold. He’s an orthopedic surgeon. I’m very proud to have him on the show and for you listeners out there that are always asking questions about are we going to do medical issues and things like that, hey, I have a doctor that even put out a book for you to help you and you can get that book.

All you have to do is go to orthopedicsurgerybook.com. Even I can find it that way so you listeners out there and it’s got a lot of things on there for you to kind of look at and all this information. I’m sure that a lot of you have questions that you’ve wanted to ask, didn’t know what to ask. We’re trying to help you here. Now, as far as asking, you know, how should you assess surgical skill, how would you do that?

Dr. Gold: Well, patient referrals are usually the best so if a friend has been happy…

Host: Um, hum.

Dr. Gold: with whom they’ve been dealing with, and have had a good result, that’s usually the best referral. However, if you don’t have answer to that or you’re not sure, then if you know any nurses, particularly nurses who work in operating rooms, or anesthesiologists, these are the people that know the physicians and surgeons who are technically gifted and the best. These people would be the best referral for the technical part. As far as personality, again this is something that would come either from direct referrals, doing a little research with your friends, checking the doctor out online to see what he’s accomplished and what he’s done. But just again, because someone is very accomplished doesn’t mean that they’re going to have the personality that you’re going to click with.

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I am very excited to announce that my web team just launched the Orthopedic Surgery Learning Center.

I will use the Orthopedic Surgery Learning Center along with this blog to further my educational efforts for the patient, caregiver and medical communities

.

If you have any ideas as to how I can enhance the Orthopedic Surgery Learning Center, please contact me.

Best regards,
Stuart

I am not a writer; I am a surgeon.

My specialty is orthopedic surgery and I have been practicing for over 23 years. My book was conceived and written out of my growing sense of discomfort when watching friends, family members and acquaintances experience long, sometimes painful, surgical procedures without a real understanding of what they were about to go through—or what outcome they could reasonably expect in the aftermath of surgery.

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