Definition
In medicine, a ligament (Latin: ligamentum) is a connective tissue structure that connects bones together. The bones involved here give the name to the corresponding ligament. For example, the ligament connecting the shin bone (tibia) and the fibula is called the “Ligamentum tibiofibulare”.
Often the ligaments are localised at joints, where they mainly serve to stabilise the joint and limit its movement to the extent provided for. The ligaments have a very limited elasticity and can be stretched or even ruptured in the event of overload or trauma, which is known as a torn ligament (rupture). Torn ligaments account for about 20% of all sports injuries and are therefore a very common clinical picture.
Cause
Torn ligaments are caused by unnatural movements, for example when falling or bending over. Excessive forces act on the joint and the securing ligament structures, which can cause injury and thus result in a torn ligament. Frequently affected are ligaments on the foot, especially on the upper ankle joint, or the ligaments of the knee.
Very often there is a typical accident mechanism for a particular ligament, depending on the type of sport. An example of this is the so-called ski thumb, which is caused by a fall in which either the thumb is not released from the loop of the ski poles in time or, when absorbing the fall with the hand, the thumb is overstretched so that the corresponding ligament tears. A further cause of torn ligaments can be, in addition to unphysiological movement, trauma acting on a joint from the outside, as is the case with a foul soccer player.
Symptoms
A torn ligament becomes symptomatic above all due to very severe pain immediately after the trauma. This pain often occurs at rest, but is particularly intensified by movement and is usually triggered by pressure on the affected area. Within a few minutes after the rupture, there is a severe swelling of the joint.
Frequently, bruising occurs over the next few hours, which is caused by rupturing blood vessels under the skin. The swollen and painful area now turns a bluish colour. Since the torn ligament eliminates its stabilizing component at the joint, on the one hand the joint becomes abnormally mobile, i.e. moves or shifts that would not be possible with a healthy ligamentous apparatus.
On the other hand, movements of the affected structures, which in contrast to the fracture can still be performed, feel unstable and unsafe. The diagnosis of a torn ligament is made by a physician, who takes the patient’s medical history to find out the symptoms and the underlying cause of the accident, which is often already very specific and thus indicates the injury of a particular ligament. During the subsequent examination, he will look for pressure pain in the affected area, swelling, bruising and any abnormal mobility.
This is followed by an X-ray examination, which is very important to rule out any accompanying bony injury. An MRI (magnetic resonance imaging) examination may also be necessary. Either if the X-ray image does not provide clear results or also in the case of complicated injuries, as soft tissue structures such as ligaments can be well depicted in the MRI and neighbouring structures such as cartilage can also be assessed. The images can also be used to plan surgery.
