Injuries of ligaments of ankle joint – rather frequent trauma. Stretchings, anguishes and ruptures of sheaves make 10-12% of total of damages of an ankle. Most often the trauma occurs in winter time at a foot podvorachivaniye on ice, ice-covered steps and platforms. About 19% of all sports injuries are the share of injuries of ligaments of ankle joint. The clinic of injuries of ligaments of ankle joint depends on their weight (stretching, an anguish, a complete separation). As a rule, it includes local puffiness, pain, various restriction of movements on volume in a joint and walking violation. In treatment physiotherapeutic methods, imposing plaster steaks, medical punctures, heat baths and massage can be used.
Injury of ligaments of ankle joint
Injuries of ligaments of ankle joint – rather frequent trauma. Stretchings, anguishes and ruptures of sheaves make 10-12% of total of damages of an ankle. Most often the trauma occurs in winter time at a foot podvorachivaniye on ice, ice-covered steps and platforms. Besides, injury of ligaments can be caused by a jump from height (often – small) or walking on an uneven surface. Injury of ligaments can be combined with an incomplete dislocation or dislocation of an ankle joint. Injuries of ligaments of ankle joint – one of the most widespread sports injuries (athletes have about 19% of all damages).
There are three groups of the sheaves which are taking part in fixing of an ankle joint. On the external surface of a joint are located calcaneal and low-tibial, forward and back collision and low-tibial sheaves which pass along an external anklebone and hold a collision bone from side shift.
On the internal surface of a joint there passes deltoid (internal collateral) the sheaf consisting of deep and superficial layers. The blanket fastens to collision and boatshaped bones, deep – to an internal part of a collision bone. The third group of sheaves presented by an intertibial sindesmoz, back cross back and forward intertibial sheaves, connects tibial bones among themselves. Most often damage of external group of sheaves meets (the forward collision and low-tibial sheaf usually suffers).
Allocate three types of damages of the copular device of an ankle joint:
- Rupture of separate fibers. In life such damage is usually called sprain of an ankle joint, however, this name does not correspond to the valid state of affairs as sheaves are not elastic at all and cannot stretch.
- Anguish of ligaments of ankle joint. A considerable part of fibers is broken off, but sheaves at the same time continue to perform the supporting function.
- Complete separation of ligaments of ankle joint or their separation from the place of an attachment.
All three types of injuries of ligaments of ankle joint are followed by identical clinical signs, however, expressiveness of these signs directly depends on weight of damage. The patient with injury of ligaments of ankle joint complains of pains when walking. Visually the swelling and bruise in the field of damage comes to light. The palpation of the injured sheaves is painful. It is possible .
At sprain of an ankle joint hypostasis local, the victim feels pains, but keeps ability to go. At an anguish of ligaments of ankle joint hypostasis extends to an external and forward surface of foot. Walking is complicated because of pain. The complete separation of ligaments of ankle joint is followed gemartrozy, the expressed hypostasis, bruises extending to a back and plantar surface of foot. Walking is sharply complicated, sometimes – is impossible because of pain.
Insolvency of sheaves is confirmed by a positive symptom of "drawer" for which check the doctor holds with one hand the patient's shin, and another – displaces foot. At a rupture of a forward portion of side linking of stop it is displaced kpered. At a rupture of side sheaves increase in side mobility of foot is noted. The research is conducted by the traumatologist in comparison with a healthy joint.
treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!!
Treatment of the first and second damage rate of ligaments of ankle joint is carried out on an outpatient basis. To the patient with sprain of an ankle joint recommend to apply a hard eight-figurative bandage a joint. In the first two days from the moment of a trauma to the place of damage put cold, and then – heat. About 2-3 days appoint physiotreatment (massage, applications of ozokerite and paraffin, variation magnetic field). To the patient allow to go.
The riparian forest the bandage will be the most effective only if to observe technology of its imposing. At damage of external group of sheaves foot is removed in position of the pro-nation (the plantar party of a knaruzha), at a trauma of internal group of sheaves – in the provision of a supination (the plantar party of a knutra), at anguishes and ruptures of intertibial sheaves – in the provision of bending. Thus the minimum tension of the injured sheaves is provided. Bandage is imposed so that each tour of a bandage pulled together the ends of the injured sheaves.
At sprains of an ankle joint working capacity is restored from 7 to 14 days in time. At anguishes of ligaments of ankle joint on a shin of the patient impose plaster to steak for a period of 10 days. Physiotreatment is appointed about 2-3 days from the moment of a trauma. For the period of treatment plaster is removed. Working capacity is restored approximately in 3 weeks.
Patients with a complete separation of ligaments of ankle joint are hospitalized in office of traumatology. At the expressed pain syndrome enter 1-2% novocaine into the field of damage. At a gemartroza carry out a puncture for removal of blood and introduction to a joint of 10-15 ml of novocaine. On a leg impose plaster to steak for a period of 2-3 weeks. Appoint UVCh to area of a trauma.
For improvement of food of the damaged area to the patient from the first days recommend to move foot fingers, to strain shin muscles, to bend and unbend a knee joint. After removal of a bandage appoint LFK, massage and heat medical baths. Within two months from the moment of damage carrying a hard bandage for a complete recovery of a sheaf and the prevention of its repeated gaps in the place of healing is shown.