Surgical Care for Ankle Sprains Comes to Lackawanna County

Ankle sprains are common recurrent injuries that occur in people of all ages. If sprained ankles are not treated correctly – and sometimes even when they are – they can become chronically unstable, leading to ongoing trauma and pain.

“An ankle sprain is an injury, or tear, to the ankle’s lateral ligament complex, which provides stability to the joint,” says Shawn Bifano, MD, orthopedic foot and ankle surgeon with LVPG Orthopedics and Sports Medicine–Dickson City. He recommends conservative treatment for the majority of individuals experiencing their first ankle sprain.

“If it’s significantly swollen and they can’t bear weight, once we ensure there are no fractures or other pathology, we immobilize the ankle for a short period of time using a boot so that inflammation calms down,” Bifano explains. He transitions patients to an ankle brace and physical therapy within one to two weeks.

Unfortunately, when ankle swelling, pain and weakness persist over a long period of time, people likely have developed chronic ankle instability.

“When the lateral ankle ligaments don’t heal in a position that’s appropriate – or they’re stretched out –this can lead to instability,” he says.

This condition sometimes causes other chronic problems, such as damage to the cartilage, osteochondral lesion of the talus or injury to the peroneal tendons. Chronic ankle instability also can lead to a higher risk for ankle osteoarthritis.

To treat chronic ankle instability, a surgeon reconstructs the ligaments back to where they attach on the fibular bone to provide stability of the ankle in the long term, Bifano explains.

“This procedure helps prevent any recurring ankle sprains and gets the patient back to their baseline physical activities or, for an athlete, back to their sport, within a couple months,” he says.

Lateral ligament reconstruction has improved over the years, thanks to better suture materials. The surgery is optimally combined with ankle arthroscopy so the cartilage can be checked for underlying lesions. Bifano is now the only fellowship-trained orthopedic foot and ankle surgeon in Lackawanna County to perform the arthroscopy and lateral ligament reconstruction.

Not all patients with ankle pain present with instability; pain can present from an underlying mechanical issue, which requires an expert evaluation, Bifano adds.

“There are many structures in the ankle, in a small area, that can be difficult to parse out. Even when X-rays are negative, there are a lot of ligaments and tendons in the foot and ankle that can cause pain,” he says