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Ligament injury
How to operate on ligament damage
Ligament injuries that affect joint stability require surgery, and different locations necessitate different surgical methods. Generally, for ligaments within a joint, such as the anterior cruciate ligament or the posterior cruciate ligament of the knee, reconstruction is performed using either autografts, allografts, or synthetic tendons to replace the original damaged ligaments. For ligaments outside of a joint, such as the medial collateral ligament, lateral collateral ligament of the knee, or the anterior talofibular ligament of the ankle, if the joint stability is compromised, suturing is generally performed during the acute phase. For chronic, long-standing injuries that affect joint stability, reconstruction is usually necessary, also using autografts, allografts, or synthetic tendons to substitute their function.
Can ligament injuries heal by themselves?
Whether ligament injury can be healed depends on the severity of the injury. Generally, there are four types of ligament injuries. The mildest is a sprain, which is when some fibers of the ligament are torn. The second type is a partial tear of the ligament, the third type is a complete tear of the ligament, and the fourth type is a combined injury, which includes damage to other structures in addition to the ligament injury. If the ligament injury is just a sprain, it can generally heal within two to three weeks with immobilization. However, partial ligament tears that are more severe may require surgical intervention. If the partial ligament injury is not severe and does not affect stability, it can also heal with about three to six weeks of immobilization. However, complete ligament tears or combined injuries often require surgery for suturing or reconstruction in order to heal.
How to treat patellar ligament injury?
First, it is necessary to qualitatively assess the injury of the patellar ligament, determining whether it is a partial or complete rupture, whether it is a simple rupture, or a compound rupture, the latter involving other injuries such as fractures or joint dislocations. The treatment of patellar ligament injuries, like other tendon injuries, follows the principle of "three earlies": early diagnosis, early treatment, and early rehabilitation. Early diagnosis has been mentioned before. Early treatment means that if surgery is needed, it should be conducted as soon as possible, as earlier surgeries often result in better postoperative recoveries. If surgery is not required, an immediate fixation with a cast or brace should be applied to keep the knee joint in an extended position, and this fixation should be maintained for three to four weeks. The third step is early rehabilitation. As the knee joint is immobilized during the fixation period, and pain and swelling starts to decrease, early functional exercises should be initiated, focusing on distal joint movement and muscular isotonic exercises, but avoiding flexion and extension movements of the knee joint. Early rehabilitation primarily aims to prevent muscle atrophy, prevent joint adhesion, and promote recovery from the condition.
What medicine is good for ligament injury?
Ligament injuries first require assessment of whether the damage is acute or chronic before considering medications. For acute ligament injuries, there are key principles to follow. First, the injured area must rest and the joint should no longer be active. Second, immediately apply cold compresses. The temperature of the ice-water mixture touching the skin should be between 4℃ to 10℃. Apply the cold compress for about 10 to 15 minutes, generally not exceeding 20 minutes. If there is severe swelling, you can continue to apply cold compresses two hours later. Then, elevate the patient's limb and apply compression bandaging to the injured site, which forms the treatment principles for acute ligament injuries. For chronic ligament injuries, different situations require different approaches. For ligament injuries that do not affect joint stability, some topical medications can be used. This can include traditional Chinese medicines or anti-inflammatory and analgesic patches, which mainly improve local blood circulation and reduce local chronic inflammation. (Please use medications under the guidance of a doctor.)
Symptoms of ligament rupture
After a ligament rupture, the area will experience pain, swelling, and restricted movement, and it will not be possible to actively extend or bend. Taking the rupture of the finger extensor tendon as an example, after the rupture caused by accidental bumps or other reasons, the site exhibits pain and cannot be straightened. When passively straightened, it will flex on its own after removing the support, unable to actively extend. These are the symptoms of functional limitation after a ligament rupture. Furthermore, some patients may also experience persistent local pain and significant swelling. At this time, it is advisable to combine local hot compresses and physical therapy. For distal finger extensor tendon ruptures, hyperextension fixation can be applied. About four weeks later, if the hyperextension fixation splint or plaster is removed, some patients can heal on their own. However, if some patients cannot heal naturally, surgical anastomosis treatment is required.
Ligament injuries should be seen by the orthopedics department.
Ligament injuries are often a type of sports injury; therefore, when a ligament injury occurs, the first choice is usually a department of sports medicine. However, many hospitals do not have a sports medicine department. In such cases, ligament injuries are generally treated under orthopedic surgery. If the hospital does not have a sports medicine department, you can visit the orthopedic surgery department. If there is no orthopedic surgery department either, and it is just a general orthopedics clinic, you can go to the orthopedics clinic. Of course, if it is a smaller hospital without a specialized orthopedics clinic, you can visit the surgery department or the emergency surgery department. After some initial treatment, you may need to visit a more specialized hospital for further medical attention.
Do ligament injuries fear the cold?
Ligament injuries should not naturally be sensitive to cold; however, due to impaired blood circulation in the damaged area or poor blood supply due to scar repair, the circulation in the injured tendons becomes worse compared to other areas. In cold conditions, this can lead to even poorer blood flow. When circulation is poor, it's hard for metabolic byproducts to be removed from the area, leading to their accumulation, which can stimulate the injured site and cause pain. Therefore, areas with ligament injuries often become sensitive to cold, as the cold causes blood vessels to constrict, leading to the accumulation of metabolic by-products and resulting in pain at the affected site.
How long does it take for a triangular ligament injury to heal?
The deltoid ligament, as a very important structure on the medial side of the ankle joint, is mainly divided into superficial and deep layers. The superficial layer generally originates from the anterior colliculus of the medial malleolus and is more superficial, making it more susceptible to injury. The deep layer originates from the posterior colliculus of the medial malleolus and is tightly connected with the talus bone, meaning that any injury likely involved significant force. Moreover, once injured, it cannot self-repair except through surgery. So, how long does it take for a deltoid ligament injury to heal? For superficial injuries, with proper immobilization or surgical repair, recovery typically takes about three weeks. For deep injuries, surgical repair can be challenging, and reconstruction is often required, extending the healing time to about six weeks or even three months.
How to recover from ligament damage
Recovery from ligament damage should be divided into two phases. The first phase is the acute phase of the ligament injury, which generally occurs within three weeks after the injury. During these three weeks, it is recommended to immobilize and minimize movement to create favorable conditions for the growth and repair of the ligament. During this period, heat application can be beneficial, and oral medications that promote blood circulation, remove blood stasis, reduce swelling, and relieve pain can be taken to facilitate the repair of the ligament. After three weeks, the continuity of the ligament is usually established. During this period, it is necessary to enhance functional exercises to prevent joint adhesion. Under the guidance of a physician, joint movements should be strengthened, combined with oral medications for promoting blood circulation, removing blood stasis, reducing swelling, and relieving pain, and also include local heat application and possibly physical therapy. With these comprehensive treatment measures, generally, a good recovery outcome can be achieved.
What should I do if the ligaments in the knee joint are injured?
Knee ligament injuries first require us to determine which ligament is damaged. The injury mechanism can help determine which ligament is affected, such as an inversion or eversion injury of the knee, which could cause damage to the medial or lateral collateral ligaments of the knee. Sometimes, knee flexion and rotation injuries may damage the cruciate ligaments of the knee. Once the specific ligament is identified, the extent of the injury must be determined. If the injury is minor, such as a contusion, rest may allow the ligament to gradually recover. If there is a tear, but the knee joint is still stable, conservative treatment can be pursued; however, if there is a tear and the knee joint is unstable, or if the ligament is completely ruptured, we recommend surgical repair to restore the stability of the knee joint.