Grade I : only stretching and sprain of lateral collateral ligament (LCL) of the ankle, maybe only mildly swelling and tenderness around tendons.
Grade I I: partially rupture of LCL, normally lesser than 50% and moderately swelling and tender around tendon, patients start to walk hardly and hardly to bear their weight.
Grade III : completely rupture of LCL, patients cannot walk on their weight and have ankle instability.
Rest, cold packing to decrease the pain and swelling, then visit the physician especially if you cannot walk. When you come to hospital, the physician will ask for history of injury and do physical examination, they may order X-ray if suspect for fracture or other injury such as: fracture malleoli , navicular bone, base of the 5 th metatarsal (toe) or syndesmotic injury.
The physician will evaluate and start the treatment to get rid of pain, swelling: elevate effect foot, cold packing, analgesic drugs, ankle support or elastic bandage application. For some patients who have severe swelling of feet may need cast or splint.
After 5-7 days when swelling and pain subsides , the physician will repeat the evaluation and patients will have physical therapy for recovery of tendons, strengthening and proprioceptive
exercise around ankle for prevention of recurrent ankle sprain which mostly spend 4-6 weeks for course of treatment.
* Cold packing , normally applied for 20 minutes until the patients feel numbness and reapply every 2-4 hours for 2-3 days*
Ankle protective shoes or ankle support, short heel shoes, avoid to walk on different level or stair, avoid the sport which easy for ankle sprain.
It depends on the severity of the sprain; if its grade 1, then they can go back to work immediately if no swelling and pain, but grade II or III may need rest about 4-6 weeks, anyway the patient should apply elastic bandage or ankle support for some period.
Similar to work, depend on the severity and mostly after no swelling and pain, the patients can do sports like swimming, bicycling, but try to avoid some sports which tend to make ankle inversion such as; dancing, running, and soccer.
After treatment or neglected sprained ankle and have had chronic sprained ankle until instability (giving way) occur at least 6-9 months. The physician will do physical examination, x-ray and magnetic resonance imaging (MRI) for confirmation, identify the tendon involvement, severity of rupture and additional conditions such as; osteochondral lesion of talus, peroneus tendon or syndesmotic injury.
There are many operative procedures for ankle instability surgery; the orthopedic surgeon will choose the most appropriate surgery to each and every patient for the best result of treatment.
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