Bone splintering in case of capsule rupture at the ankle joint

The diagnosis of a capsule tear at the ankle joint is in most cases based solely on a detailed anamnesis and physical examination. Severe swelling after an accident, which is accompanied by pain and restricted movement, indicates an injury to the ligaments and structures of the joint capsule. Nevertheless, an additional X-ray should be taken in the case of serious injuries, as there is an increased risk of bone involvement in the ankle joint.

In contrast to other joints, involvement of bone fragments of the lower leg often results in surgery. Under certain circumstances, an MRI image can also be taken to better assess the injury. The MRI examination is only necessary in rare cases.

A clinical examination, as well as an X-ray check for bone involvement, is often sufficient to make a diagnosis of capsule rupture. The MRI can display soft tissue in particular with high resolution and is therefore well suited to assess capsule damage, swelling, torn ligaments and many other injuries to the soft tissues of the ankle joint. However, it is a rather complex and expensive diagnostic procedure, which in most cases does not result in a change in therapy and is therefore unnecessary. In the case of long-standing complaints, the MRI examination can provide important indications of undetected damage to the ligamentous apparatus of the ankle.

Treatment

The most important part of the treatment takes place within the first two days after the accident. To reduce the healing time, pain and swelling, immobilization, cooling, compression and elevation of the foot should be started immediately. These measures can stop smaller bleedings earlier, thus reducing the swelling.

Immobilization can be achieved at the ankle joint using splints, bandages and tapes. In the following weeks, rest and immobilization remain the most important treatment measures. The swelling requires time to resorb and the capsule tear may take several weeks to heal.

In order to relieve the pain and to allow a slow muscle and movement build-up, sufficient pain medication should be taken. The ankle joint is a strong joint that carries a lot of body weight. In case of injuries such as a rupture of the capsule, it should be protected and immobilized, which is only partially possible with a tape bandage.

Rigid and elastic tape bandages are used. They can be applied to the ankle joint under the guidance of a doctor or physiotherapist and the joint guidance and movements can be splinted. A rigid tape bandage has much stronger splinting effects.

The effects of the tape are to perform movements more consciously, to prevent rapid movements and overstretching in the joint and to promote the muscle activity of the joint during movements. A tape bandage after a rupture of the capsule is particularly useful after a few weeks of healing to slowly and consciously allow movements to take place again and to rebuild. There are various splints for the ankle joint, which can be used especially in the early treatment of capsule tears.

A splint is rigid and can thus immobilize the joint in the event of an acute rupture of the capsule and prevent movement. Many splints can be adjusted to allow certain movements. Thus, the splint can be used to provide both initial protection and slow movement in a controlled manner.

The brace represents a further therapeutic option for immobilizing the ankle joint. In most cases, bandages are made of an elastic, soft material. Their main tasks are to immobilize, slow down movements and make the muscles and individual movements in the joint more conscious.

Overall, the bandage results in significantly less immobilization than a splint or rigid tape bandage. For this reason, the bandage should only be used after a few weeks for further therapy or as a prophylaxis against new injuries in the event of capsule rupture. A rupture of the capsule rarely requires surgery.

As a rule, the capsule heals on its own, so that a complete restoration of movement is possible. However, in the case of bone involvement, surgery may be necessary. At the ankle, the joint capsule is formed by various ligaments and muscles involved in movements of the lower leg and foot.If the ligaments are subjected to strong tensile loads, important bone parts that are responsible for the stability of the ankle joint may splinter off under certain circumstances. In many cases, these must be surgically fixed with screws or plates. The dreaded ankle fracture, a fracture of the fibula, also requires extensive surgical treatment to ensure stability.