What is a torn ligament?

Twisted knees, twisted feet or dislocated shoulder: When a joint hurts, swells and turns blue, a common cause is a torn ligament. Ligaments surround muscles and joints to stabilize movements such as flexion, extension, and rotation. When overloaded, the fiber bundles can tear or even tear. A torn ligament can affect one or more ligaments. Doctors also refer to the torn ligament as a ligament rupture (rupture = tear).

The most common ligament tears:

• External ligament tear at the upper ankle
• Cruciate ligament tear
• Outer ligament tear on the knee
• Inner ligament tear on the knee
• Torn ligament at the bases of the thumb (so-called ski thumb)
• Inner ligament tear at the ankle
• Torn ligament on the shoulder
• Torn ligament on the elbow

If the joint is still stable and the structures are intact, orthopedic surgeons speak of a ligament stretching or strain . However, it can also happen that a tape tears partially or completely if the maximum freedom of movement is exceeded. If the ligament is completely ruptured , injuries also occur to the articular cartilage or to the cartilage between the meniscus at the knee joint or the socket edge at the shoulder joint.

Serious accidents can lead to a complete dislocation , a so-called dislocation. This mainly happens in the shoulder or elbow joints because they are very flexible. With such a dislocation, not only do the ligaments tear, but also the joint capsule.

Torn ligaments: The causes are usually sports accidents

The most common causes of a torn ligament are sports or work-related accidents. For example, when a footballer twists his knee while dribbling , a basketball player kinks while laying a lay-up, or a winter sports enthusiast catches his skis and falls. The normal range of motion of the joint is exceeded due to the hard impact or the compression. Ligaments, joint capsules and other joint cartilage are injured. The typical cause of a ligament at the ankle joint (ankle) is for example the twisting to the inside. The outer ligament is overstretched, pulled or torn. If the foot kinks outwards, the inner ligament can be injured.

If you fall and fall on your outstretched arm or upper body, you can also tear a ligament on your shoulder, hand or arm. Torn ligaments in the elbow and shoulder are often accompanied by dislocation of the joint. Ball sports, falls, bruises or handicrafts are responsible for a torn ligament on the finger.

 

Anatomy of the human knee: The menisci surround the knee joint in a circle and form a kind of shell in which the thigh bone rests. This is fixed in the knee joint with the help of the cruciate ligaments.

Torn ligament: treatment begins on site

If a ligament rupture is suspected, the injured joint should be immobilized immediately at the scene of the accident, cooled, raised and, if necessary, stabilized with a compression bandage. This will prevent the swelling from increasing. The four most important steps of the first self-treatment follow the PECH rule: pause (P), ice-cooling (E), compression (C) and lying on top (H). A completely dislocated joint should be corrected as soon as possible. 

There are two options for medical treatment: Conservative treatment immobilizes the joint with bandages, splints or orthotics. A torn ligament can also be operated on. This decision as to which therapy is appropriate depends on how old and active the patient is and how unstable their joint is. Sports-oriented patients in particular benefit from prompt surgery because they can then put more strain on the ligaments after recovery.

Torn ligament: conservative therapy

Torn ligaments on the ankle, shoulder and arms heal well without surgery. Doctors often treat torn ligaments on the foot, ankle or knee with a special walking splint (orthosis). They support the joint and take over the function of the broken ligament. If possible, the patient should wear the stability splint for about six weeks without interruption, including when sleeping. In addition, the joint is cooled and treated with lymphatic drainage so that the swelling subsides. If it is no longer necessary to wear the splint, physiotherapeutic exercises are used to build muscle and stabilize the joint.

For athletes, specialists often recommend supporting bandages or tapes after the splint , which stabilize the joint and protect it from renewed injuries. This effect has not been proven by scientific studies. “Bandages convey security and serve as psychological support. Whoever wears them does not put too much strain on the area, ”says Tobias Jung, senior orthopedic surgeon at the Charité's Virchow Clinic. Bandages must be applied professionally by a doctor or physiotherapist.

Torn ligament: when is an operation necessary?

Serious ligament tears, in which the joint function is severely damaged, must be operated on, for example drastic knee ligament ruptures, skier's thumb or ankle trauma. The timing of the operations depend on the type of injury. In the case of fresh ruptures, the procedure can be carried out within 24-48 hours, for example in the case of torn cruciate ligament or sutured meniscus ruptures. In most cases, the inflammatory reaction in the joint must first subside before an operation can be performed. If the cruciate ligament ruptures, this can take four to six weeks. 

Until the time of the operation, doctors treat the joint functionally conservatively with stabilizing orthotics.

Torn ligament: surgery with or without a transplant?

An arthroscopy is the most common way to operate a torn ligament - but also to clarify the diagnosis. Especially in the case of knee injuries, orthopedic surgeons often insist on an arthroscopic examination in order to be able to identify and treat accompanying knee injuries, meniscus or cruciate ligament injuries.

In the best case, torn ligaments can be fixed again by surgery. Torn ligaments on the thumb, for example, are usually sewn and reattached to the bone with a wire or screw. Torn ligaments in the knee, on the other hand, often have to be replaced by a transplant , which can take over the stabilizing function in the damaged joint. The patient can choose between various surgical techniques and transplants. In the case of knee injuries, the body's own transplants have become the standard, as they have a tear strength and elasticity comparable to that of the broken ligament. They differ in terms of their removal and their anchoring options.

Common grafts for ligament tears in the knee joint:

• The urinary string transplant (knee flexor tendon) is popular because the unproblematic removal hardly causes any pain, disturbances or scars. If transplanted correctly, it can achieve the elasticity of the natural cruciate ligament.
• The patellar tendon graft is removed from below the kneecap. It can stably replace the torn ligament, and it heals quickly after being inserted. The disadvantage: During the removal, a “typical front knee pain” arises and muscle strength can be lost.
• The quadriceps tendon of the thigh muscle is suitable as a graft for knee surgery because its biomechanical property are similar to those of the cruciate ligament. However, the demanding removal can weaken the thigh function.

Doctors also like to take a tendon graft from the knee for torn ligaments in the shoulder and elbow, whereas in the case of the ankle, the graft often comes from the fibula muscle. The grafts are removed using arthroscopy and used in place of the torn ligament. For fastening purposes, the doctor selects, for example, metallic or bioabsorbable interference screws, staples, pins or fixation buttons (buttons) as anchors.

Torn ligament: rehabilitation and follow-up treatment

Through a rehabilitation lasting several weeks, the patient should regain his freedom of movement, resilience as well as muscular control and coordination as quickly as possible. In physiotherapy, specific exercises are carried out for this purpose. There are doctors who prescribe an orthosis during rehab, but the benefits of this approach have not yet been scientifically proven, accordings to the professional association for orthopedics and trauma surgery.

inbusinessworld   digitalmarketingtrick  thewebscience  itgraviti  beloveliness  allmarketingtips