Torn ATFL....what now?

• 

  Cheapo Moose on 06/06/2018 - 19:23

  +6

  This might be out there… but I reckon you're better off asking medical professionals… not a bunch of tight-arse, coupon hoarding, haggling, OzBargainers….

• 

  DrJDr on 06/06/2018 - 19:58

  Hey Mikerobertsn,

  First off, disclaimer - medical advice from someone over the internet should not replace a thorough physical examination and a doctor reviewing your scans in person.

  The ATFL is the most commonly injured ligament in a low grade ankle sprain (it is also the weakest of the four lateral ligaments). A tear of the ATFL by itself usually means low level injury as a complete rupture of the ligament is accompanied by injuries to the other lateral ligaments. In isolation, it would only require surgery in extreme circumstances (i.e. multi-ligament ruptures, continuing pain and instability despite thorough non operative management or a if a sizable bit of bone has been pulled off).

  Unfortunately with ankle sprains, once sprained, you will be more likely to sprain it in the future. The best way to combat this can be by strapping your ankle when doing activities where you are more likely to sprain it, e.g. sport, as well as proprioceptive training exercises.

  Physio is definitely the way to go.

  See the below link for more information:
  https://www.orthobullets.com/foot-and-ankle/7028/low-ankle-s…

  Also, see this link for an evidence based approach to ankle sprains:
  https://www.ncbi.nlm.nih.gov/pubmed/10028133

  All the best with your recovery.

• 

  mbck on 06/06/2018 - 21:01

  +2

  Only atfl. I'd moon boot 6 weeks. It'd fuse and then the hard work begins. Your physio will slowly give you exercises that helps your balance and strength.

  I'd be very surprised if you go down surgery.

  Just imo

• 

  nicread on 06/06/2018 - 22:19

  Hi Mike,
  I'm a physio in Brisbane, feel free to message me (about the injury, not state of origin)

• 

  EightImmortals on 07/06/2018 - 07:40

  -1

  Have a look into stem cell treatment, it's going gangbusters ATM (apparently). Not sure if would help your particular injury but call one of the Stem Cell clinics and have a chat to the doctors(google them). Surgery would be a LAST resort for me as I don't know anyone who has made a full recovery afterwards. Also, ligaments take forever to heal up on their own so if you've only just injured it give yourself a year or two to heal up. But yeah, talk to the pros and make a decision.

• 

  Mikerobertsn on 08/06/2018 - 11:37

  Thanks, everyone, there is a lot of good information here to consider, the evidence-based approach paper was quite interesting. The physio said to hold off on seeing a surgeon for the moment so I might do that.
  I didn't know it was possible, but the physio said there is a chance that the complete tear will reattach so hope for that, the stem cells look really interesting looking like they will promote rapid healing. I'm just a bit weary about the stem cell option atm, its not covered by Medicare or private health, its not just the cost but most things that aren't covered like this are normally too new without enough trials being done, not sure if I want to be a guinea pig.

  • 

    EightImmortals on 09/06/2018 - 08:38

    -1

    I know what you mean, but 'new' for insurance companies and doctors actually means decades in the real world. :) As for costs, that's up to you but I would rather pay a few grand with a chance at a full and natural recovery than end up paying even more (probably) for invasive surgery that will keep me in hospital and probably never fully recover. For me it's worth a shot, you might be different.

    There is a procedure called Regenexx which was patented to treat ACL tears ( https://www.regenexx.com/regenexx-acl-repair-for-torn-anteri… ) and a mob here in Australia that does it ( http://www.nssm.com.au/regenexx-procedures/ ). Otherwise you could try to get on a clinical trial? http://www.stemcellsaustralia.edu.au/About-Stem-Cells/Stem-C…

    All the best.