Consultant Orthopaedic Surgeon, Mr Kumar Kunasingam talks about ankle injuries and how they are assessed and treated.
"The ankle is a busy part of the body! It takes the weight of our bodies and has to answer to where we want to go and when and whats under our feet at the time. It does so by a series of joints, ligaments, tendons and beautiful moving surfaces to allow us to glide from A to B and beyond.
With all of this action it is also quite prone to injuries accounting for a lion share of orthopaedic injuries taking you to A and E with pain, swelling and giving way. Everyday activities such as running for the train, stepping awkwardly on various obstacles we have lying around at home or indeed sporting activities can lead to ankle injury!
You don't have to be an athlete to injure your ankle and often expedient specialist attention will help to make an accurate diagnosis and offer tailored treatment and support. A trip to an orthopaedic foot and ankle specialist offers the chance to know what happening with your ankle. Take away uncertainty of what injury is causing the pain and allow us together to plan and predict recovery! The huge weight of not really knowing is suddenly gone and you can begin to understand which bit of your ankle needs help and how it will best be given.
Accurate assessment by an orthopaedic surgeon will offer fast and rapid diagnosis, onward investigations and the benefits of potential surgery to speed up recovery.
Being qualified in both orthopaedics as a foot and ankle specialist and sports medicine gives me a unique insight into this journey. I do believe less is more and want to get ankle injuries mobile and better as soon as safe and possible.
A thorough history will allow me to focus on what structures are at risk. A rapid detailed review with X rays and often an MRI scan will help to put the picture together from the clinical findings (ie where the pain is and how it happened) and the changes seen on X ray/MRI. This is a quick and painless way to rule out nasty injuries or bring these type of injuries to focus.
I am an exponent of keyhole or arthroscopic surgery to foot and ankle. This allows access to damaged areas through very small portals but gives me a magnified and details view of the areas of the ankle that need attention.
As ankle twist and roll a series of event occur from stretching of ligaments to the clashing together of the pristine articular cartilage causing wear and potentially 'chunks' of cartilage being lifted up and either flapping away in the ankle or breaking away and forming what we refer to as a loose body. This can cause awful catching pain of giving way! This unfortunately can often lead to further injury to the ankle.
Keyhole/arthroscopic surgery allows me to take away small damaged flaps of cartilage before they become big ones causing bigger problems. It also is a great way of taking down scar tissue and small damaged bone spurs that the body creates to protect itself from future ankle injuries (osteophytes).
Recovery is quick and patients are asked to walk straight away! Wounds healing in just under 2 weeks and often I encourage immediate physiotherapy to prevent and excess stiffness!
Ideally coming to see me as close to the injury as possible get the above processes in motion early to excellent outcome. This does not always have to be the case as more often than not we try and 'walk' these injuries off and often a mild injury resolves within a few days. If however, the ankle is slow to recover after a week then it really is beneficial to know what has happened and then focus and predict on getting better asap and this can be easily done by a trip to me!"