Lateral ligament injuries are the commonest injuries from an ankle sprain. The lateral ligaments are the tight bands on the outer aspect of the ankle which link the bones and maintain stability of the ankle joint. The injuries occur after twisting injuries or inversion of the ankle. After a sprain you will have swelling and often bruising on the outer aspect of the ankle. The majority of ankle sprains are minor and will be successfully treated initially with rest, ice, compression and elevation, followed by a combination of bracing and good quality physiotherapy.
In some people a small piece of bone will be pulled off with the ligament. In other patients more severe fractures can occur. These are usually picked up with x-rays. Sometimes there can be chips off the joint surface (known as osteochondral injuries).
People with more severe injury to the lateral ankle ligament will experience ongoing pain or instability in the ankle. They will often describe the ankle regularly giving way, feeling weak or losing confidence in the ankle. Walking on uneven ground becomes more difficult because of loss of the normal restraint of the ankle. Some people are unable to return to running or other sport. If left untreated there is a risk of this leading to osteochondral lesions or to development of arthritis in the ankle.
Sometimes even the more severe injuries will improve with good physiotherapy and the correct brace. In this situation the other option is surgery to stabilise the ankle. You would have a MRI scan to check there are no other injuries requiring treatment at the same time.
Find out more about surgery to stabilise the ankle (ligament reconstruction).
Many people having ankle ligament reconstruction also require arthroscopic surgery of the ankle.