Dr Naudé addressed members of the South African Society of Physiotherapy on 18 July 2024 at Vital Touch Physiotherapy Centre on the presentation and management of Syndesmosis and Ankle Ligament Injuries.
When a person sprains their ankle during a sport or leisure activity, it is often difficult to know whether they should go to their general practitioner, to a foot specialist or to a physiotherapist. Quite often patients opt not to seek medical help due to the fear of surgery.
Therefore, the talk aimed to empower physiotherapists to understand how typical ankle ligament injuries and syndesmosis injuries present and the conservative and surgical treatment options.
The first topic is related to syndesmosis injuries. The key takeaways are that:
A high clinical index of suspicion is important in these injuries as up to 20% goes undetected in clinical examination
Delayed examination of 5-7 days works best as this allows the swelling to settle and the hypersensitivity of the soft tissues to relax allowing exact examination of all the individual structures
A weight-bearing X-ray will confirm clinical suspicions and the classification of the injury
Grade 1 injuries are best treated conservatively, but Grade 2 and Grade 3 injuries need accurate surgical management to ensure proper reduction, together with adequate rehabilitation
It is important to note that there is a longer RTP (Return to Play) period than in lateral ankle ligament injuries.
The second topic is related to lateral ligament injuries of the ankle. The key takeaways are that:
Injuries to lateral ligaments are common
Most injuries are effectively treated by conservative, functional rehabilitation in the acute setting
Chronic instability can be differentiated into functional or mechanical instability
Functional instability should be managed with functional rehabilitation
Mechanical instability is managed surgically
Anatomic repair is the gold standard
The elite athlete may benefit from early surgical intervention for acute grade 3 injuries
Thank you to the team at Vital Touch Physiotherapy Centre for hosting this excellent event!
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