High Ankle Sprains: Treatment Options

High Ankle Sprains: Treatment Options

If a patient suffers a high ankle sprain, most health care providers would recommend some form of treatment. Leaving it alone or trying to fight through the pain will likely lead to more pain. The inability to do normal activities and possibly even ankle arthritis.

Mild or even moderate high ankle sprains can be treated without surgery. Let us go through this chart to review a patient's progression during nonsurgical or nonoperative treatment. If the patient and doctor decide to try nonoperative treatment, the first phase focuses on bringing down the pain and swelling with rest, ice, compression, and elevation, and using some type of brace or boot to keep the ankle stable. The patient should not put any weight on it at first.

As the swelling and pain go down, the patient can start to gently put some weight on the ankle and begin some light therapy exercises. Eventually, they can put all of their weight on it, working on balancing on one leg and working on walking normally without any pain.

During the last phase, a few months down the line, the patient should be able to do heel raises on just that leg, start running without pain, and go back to their normal activities without any issues.

For a more severe injury, surgery may be recommended. Some surgeons will take a look inside the ankle joint with a camera to check and see if there is any other injury first. Recently, new, smaller scope cameras have come out, so the surgeon only has to make a small needle poke hole to look inside the joint.

If the patient just had a high ankle sprain, the standard surgery in the past was to take long screws and put them across both the fibula and tibia, holding the bones close together until they healed.

However, those screws could break, and a second surgery would be needed if they had to be taken out. With newer technology, two small buttons connected with suture can replace the large screws, and a second surgery probably would not be needed.

Even if the patient had a fracture along with the high ankle sprain, a plate could be used to fix the fracture, and the suture button device can be placed through the holes in the plate, or a long, skinny rod could be put up through the fibula to hold the fracture in place. This rod has two holes in it, which is where the suture button device would go through.

On this x-ray, you can see the rod and the buttons on the outside of the bones. The suture does not show up on the x-ray, but you can see the small tunnels that were drilled through the bone where the sutures pass through.

As you can see, there are many ways to treat a high ankle sprain with surgery, along with any other injuries that might have happened. Recovery after surgery can change depending on what had to be done but will likely involve being in a splint or cast of some sort for a couple of weeks, followed by a walking boot.

As the pain and swelling decrease after surgery, the patient will start physical therapy to increase the movement and strength of the ankle, then advance to balancing exercises. When the therapist and the surgeon give the green light, the patient can start running and jumping and return to their normal activities, as well as any sports they enjoy.