Torn ligament – painful consequence of an accident
Who does not know that? Once, you inattentively stumbled over a stone and twisted your ankle painfully. Fortunately, the pain usually goes away after a few minutes, but it can also result in a ruptured ligament. Find out more about typical symptoms of a ruptured ligament and standard treatment options here.
What is a ruptured ligament?
Ligaments are strong connections between bones, consisting of muscular connective tissue stabilizing and stabilizing the joint. Almost every joint is secured in this way, but some joints put more strain on the ligaments of our movements than others and are, therefore, more prone to injury during specific movements.
Like ligaments, tendons are solid connective tissue, but they attach muscles to bone. They are of different lengths and can transmit muscle power over longer distances. Many muscles that move the hand are on the forearm, and only the long tendons pull into the hand area.
There is often a connection between tendons and ligaments because they merge: a long thigh muscle ends with its tendon in the ligament that protects the kneecap. One can imagine that our weight additionally stresses ligaments on the knees and legs and that an unfortunate movement there has more severe consequences than on the arm or shoulder.
Origin: How does a ligament rupture occur?
Ligaments are often medically named for the bones they connect – the ligaments on the lateral ankle are called the anteroposterior fibulotalar ligament (anterior and posterior ligament between the fibula and the talus) and the fibulo-localcaneal ligament (ligament between the fibula and heel bone).
When a ligament tears (also called a ligament rupture), the force acting on the ligament is so great that the taut connective tissue tears, an X-ray must always be used to check where the ligament is torn if it has torn out with its bony attachment, the bone structure will appear irregular on X-ray.
If a ligament does not tear but is stretched by a thoughtless movement, it is called a sprain or strain (distortion). It can be more painful than a torn ligament.
Causes: What causes a ligament tear?
Because the connective tissue of a ligament is usually solid, a ligament tear will only occur if a disproportionate amount of force is applied to the ligament. Unfortunately, we can apply this force with our body weight, be it a fall on our hand or a wrong movement with our knee or foot.
Torn ligaments in the foot (ankle, ankle)
In theory, any ligament in our body can tear, but in practice, ligament tears in the foot – affecting the upper ankle – or knee are the most common. In recent years, ligament tears on the thumb, the so-called ski thumb, have also been observed more frequently.
Luckily, multiple ligament tears are less common in polytrauma, such as those that occur in serious car accidents. In addition to many other life-threatening injuries, broken bones or joint injuries often occur there, which entail lengthy treatment.
As already mentioned, there are three ligaments in the upper ankle joint, all of which can tear. However, the front outer ligament tears most frequently, then the middle one, which pulls towards the heel bone, and the rear outer ligament tears least frequently. It is rare for all three outer ligaments to tear, but it is essential for further therapy. In all running sports, there is a risk of provoking a torn ligament by choosing unsuitable footwear – however, you can also accidentally twist your ankle when going to the bakery.
Torn ligaments in the knee
Four ligaments in the knee can be injured: the inner and outer ligaments and the anterior and posterior cruciate ligaments. In addition, the knee joint is something extraordinary. Here, the ligaments not only wrap around the outside of the joint but also connect to the inside.
Two pieces of cartilage, the menisci, lie between the thigh and lower leg bones. But that’s not all: The inner meniscus is connected to the inner ligament, so if the ligament tears, the meniscus is also affected. The inner or cruciate ligaments are often torn, and the outer ligament is almost never affected.
A typical sport for knee ligament injuries is skiing.
Ski thumb: torn ligament on the thumb
The ski thumb is also a typical ligament injury for this sport. If you don’t get your thumb out of the loop of the ski pole when you fall and twist your thumb, the ligament on the inside of the base of the thumb can tear.
Symptoms: How does a torn ligament manifest itself?
Often, the tearing of the tape causes an audible noise. Otherwise, the affected joint will hurt, swell and cause bruising. The most important sign, however, is the changed mobility of the joint, which is checked during the medical examination. Especially with ankle or knee injuries, you feel unsafe on the affected leg – the joint is unstable.
The severity of the pain and the bruising are very different individually. The X-ray and the doctor’s examination alone may result in the diagnosis of a ligament rupture. However, the patient has hardly any symptoms apart from a slight unsteadiness when walking, for example.
Diagnosis of torn ligaments
The X-rays required for diagnosis are often very uncomfortable for the patient. The affected ankle is clamped in a device that is somewhat reminiscent of an instrument of torture. However, the doctor can use correctly performed X-rays to determine whether and what type of ligament tear is present.
Various tests on the knee joint (Lachmann test, drawer phenomenon, pivot shift test) show which ligament structures are torn. In addition to X-rays, the imaging methods computed tomography (CT) and magnetic resonance imaging (MRI) are used to clarify whether bones or menisci are also injured.
Treatment for a torn ligament
While a few years ago, torn ligaments in the upper ankle were treated generously with surgery, the procedure has now changed. Athletes are only operated on when all three outer ligaments are torn. The ligaments are restored with a periosteal flap.
Otherwise, conservative therapy has proven itself: In addition to relief, a decongestant ointment bandage and rest, the joint is stabilized with stabilized or well-wrapped tape bands. Physiotherapy exercises are used early on to train the long foot muscles.
Internal ligament tears on the knee are treated conservatively: In addition to relief and early mobilization, physiotherapy is also used here so that the immobilized muscles do not get completely out of exercise.
Treatment of a cruciate ligament tear
The situation is different with a cruciate ligament tear. Only elderly patients who are not very active will not be suggested surgery . Since a cruciate ligament rupture leads to permanent instability of the knee joint and the cartilage surfaces no longer lie precisely on top of each other due to the lack of ligament guidance, osteoarthritis of the knee joint occurs more quickly, i.e. wear and tear of the joint cartilage.
Since cruciate ligaments cannot be sewn up, a so-called cruciate ligament plastic surgery must be performed, in which a piece of the body’s tendon is inserted in place of the cruciate ligament. Here, too, mobilization is quick; otherwise, scarring can restrict full mobility in the knee joint. However, after a cruciate ligament injury, it usually takes almost a year before you can practice any sport again. To avoid thrombosis in the leg that is not moved very much, thrombosis prophylaxis (usually in the form of an injection) is carried out until the mobilization mobilization.
Treatment of the ski thumb
The ski thumb only needs to be operated on if the thumb joint can be opened up too much. Otherwise, a three-week immobilisation is usually sufficient for the torn ligament to heal.
What complications can occur?
If a torn ligament goes undetected and the ligament fails to heal, the joint can become chronically unstable. This leads to increased twisting of the foot in the upper ankle, pain and gait instability in the knee and reduced strength in the thumb when gripping.
If such instability has occurred, there is usually no way around the operation. So it would help if you did not take an injury that can lead to a ligament tear lightly but have it clarified by the doctor whether a ligament tear is present and that The joint with the injured ligament can then be treated conservatively or surgically according to the doctor’s instructions.
