Ankle Ligament Repair

What is Ankle Ligament Repair

Ankle ligament repair is a surgical procedure to fix a torn or stretched ligament in the ankle. Ligaments are strong bands of tissue that connect bones together. Ligaments in the ankle keep the ankle bones in place and stabilize the joint.

You may need this surgery if other treatments have not worked to repair a damaged ligament. The procedure is usually done on ligaments that are found on the outer side of the ankle.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reaction to medicines.
• Damage to nerves or blood vessels.
• A blood clot that forms in the leg and travels to the lung (pulmonary embolism).
• Delayed wound healing.
• Failure of the procedure.

What happens before the procedure?

• Stop smoking or smoke less for as long as possible before your procedure. If you need help quitting, ask your health care provider.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your healthcare provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines, steroids, or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
• You may have imaging tests of your ankle.
• Ask your health care provider how your surgical site will be marked or identified.
• Plan to have someone take you home from the hospital or clinic.

What happens during the procedure?

• To reduce your risk of infection, your health care team will wash or sanitize their hands.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
• Your ankle area will be cleaned with a germ-killing (antiseptic) solution.
• An incision will be made over your ankle.
• Your surgeon will repair the damaged ligament using the method that is best for your injury. Ankle ligament repair may be done several ways:
  • A torn ligament may be stitched back together.
  • A tendon may be used to replace or strengthen a badly damaged ligament. The tendon may be taken from your foot or ankle area (autograft) or it may be from a donor (allograft).
  • A stretched ligament may be tightened by putting stitches (sutures) or anchors on the ankle bones.
• Your incision will be closed with sutures and covered with a bandage (dressing).
• Your ankle will be placed a splint or cast.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You will not be able to put body weight on your affected leg. You will be given a walker or crutches to help you move around.
• Your ankle will be raised (elevated) to manage swelling and help you heal.
• You will be given pain medicine as needed.
• You will continue to have a splint or cast on your ankle.
• Do notdrive for 24 hours if you received a sedative. Ask your health care provider when it is safe for you to drive.
• You may be shown how to do exercises to improve the strength and movement of your ankle.
• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.

Ankle Ligament Repair, Care After

What can I expect after the procedure?

After your procedure, your foot and ankle will be in a splint or cast. It is common to have:

• Some pain or soreness.
• Numbness or tingling.
• Swelling.

Follow these instructions at home:

If you have a splint or cast:

• Wear the splint or cast as told by your health care provider.
  • Swelling may cause your splint or cast to feel too tight. You will be shown how to adjust your splint or cast to make it feel more comfortable. Adjust your splint or cast if your toes tingle, become numb, or turn cold and blue.
  • Remove your splint only as told by your health care provider.
  • Do notremove any padding.
• Do notwalk on your cast until it is hard and dry and your health care provider tells you it is safe to walk on. It may take 1 hour or up to 3 days for your cast to dry, depending on the type of material that it is made of.
• Keep your splint or cast clean. Do notlet your splint or cast get wet if it is not waterproof.
• Do notstick anything in your splint or cast to scratch your skin. Doing that increases your risk of infection.
• Check the skin around your splint or cast every day. Tell your health care provider about any concerns.
• You may put lotion on dry skin around the edges of the cast. Do notput lotion, powders, or deodorant on the skin underneath the cast.
• Do nottrim rough edges from your cast unless your health care provider tells you to.
• Your cast or splint may be replaced with a removable cast that covers your entire ankle and foot (walking boot). Wear the walking boot as directed by your health care provider.
  • You may take off the walking boot for sleeping and bathing.
  • After a few weeks in the walking boot, you may be able to start putting weight on your ankle, if directed by your health care provider.

Bathing

• Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• If your splint or cast is not waterproof, cover it with a watertight covering when you take a bath or a shower.
• Keep your bandage (dressing) dry until your health care provider says it can be removed.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

• Move your toes often to avoid stiffness and to lessen swelling.
• Put ice on your ankle:
  • Put ice in a plastic bag.
  • Place the ice on top of your splint or cast.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Raise (elevate) your ankle above the level of your heart while you are sitting or lying down.

Driving

• Do notdrive for 24 hours if you received a sedative during your procedure.
• Do notdrive or use heavy machinery while taking prescription pain medicine.
• Ask your health care provider when it is safe to drive if you have a splint or cast on your ankle.

Activity

• Try to walk as much as possible without putting weight on your ankle. Use crutches or a walker as told by your health care provider.
• Ask your health care provider what activities are safe for you.
• If physical therapy was prescribed, do exercises as told by your health care provider.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Quit smoking or smoke less. Tobacco can delay healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have any of the following symptoms that get worse or do not get better:
  • Pain.
  • Stiffness.
  • Tingling.
  • Numbness.
• Your splint, cast, or walking boot gets damaged.
• The skin around your splint or cast becomes irritated.
• Your cast cracks, becomes soft in any area, or gets rough edges.
• Your skin underneath your cast or splint is itchy, and the itchiness and does not get better.

Get help right away if:

• You have difficulty breathing.
• You cough up or spit up blood.
• You have chest pain.
• Your heart beats more quickly than normal, or you feel it skipping beats.
• You have severe pain.