title: Medial ankle pain after lateral ligament rupture.
abstract: After a severe ankle sprain the incidence of residual complaints, particularly on the medial side of the joint, is high. We studied a consecutive series of 30 patients who had operative repair of acute ruptures of lateral ligaments. During operation, arthroscopy revealed a fresh injury to the articular cartilage in 20 ankles, in 19 at the tip and/or anterior distal part of the medial malleolus as well as on the opposite medial facet of the talus. In six patients, a loose piece of articular cartilage was found. We conclude that in patients with a rupture of one or more of the lateral ankle ligaments after an inversion injury, an impingement occurs between the medial malleolus and the medial facet of the talus. Patients with a lesion of the lateral ankle ligament caused by a high-velocity injury (a faulty landing during jumping or running) had a higher incidence of macroscopic cartilage damage (p < 0.01), medially-located pressure pain (p = 0.06) and medially-located complaints at one-year follow-up (p = 0.02) than those with low-velocity injury (a stumble).
authors.affiliation: University of Amsterdam, The Netherlands.
authors.forename: C N
authors.initials: CN
authors.lastname: van Dijk
authors.forename: P M
authors.initials: PM
authors.lastname: Bossuyt
authors.forename: R K
authors.initials: RK
authors.lastname: Marti
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D018771:Arthralgia / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D001175:Arthrography; D001182:Arthroscopy; D001265:Athletic Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017844:Lateral Ligament, Ankle / Q000293:injuries* / Q000601:surgery; D008297:Male; D012421:Rupture; D013180:Sprains and Strains / Q000150:complications / Q000175:diagnosis / Q000601:surgery