Choosing the Right Hardware for Ankle Ligament Repair: Key Considerations

How to choose screws for a torn ligament in the right ankle?

After today's ultrasound, the doctor said that the ligaments in my right ankle are torn, specifically the two most commonly injured ones, and I need to undergo ligament repair surgery.
I would like to ask Dr.
Chen: 1.
Is there a high probability that the cheaper metal screws will come loose in the future? 2.
Which would you recommend between metal screws and absorbable screws? (Which has a better cost-performance ratio?) 3.
After the repair surgery, will I be able to continue playing in soccer matches? 4.
What is the likelihood of the ligaments re-tearing after the surgery?

tiyu laoshi, 20~29 year old female. Ask Date: 2021/07/30

Dr. Chen Yongxue reply Orthopedics

Hello,
1.
Is the probability of cheaper steel nails falling out high in the future?
ANS: Not necessarily.
2.
Which would you recommend, steel nails or absorbable screws? (Which has a better cost-performance ratio?)
ANS: Absorbable screws.
3.
Can I continue playing football after the suturing surgery?
ANS: You need to undergo proper rehabilitation.
4.
Is the probability of the ligament re-rupturing high after surgery?
ANS: Yes, because the ligament has been previously torn and cannot fully return to its original, uninjured state.

Thank you.

Reply Date: 2021/07/30

More Info

When it comes to ankle ligament repair, particularly after a diagnosis of a torn ligament, there are several key considerations regarding the choice of hardware and the overall surgical approach. Here’s a detailed response to your questions:
1. Choosing Affordable Hardware and Its Risks: Opting for cheaper hardware, such as steel screws, may raise concerns about their long-term stability and the likelihood of complications. While cost is an important factor, it’s crucial to prioritize quality and the reputation of the hardware used. Cheaper materials may not have the same level of reliability or durability as those from reputable manufacturers. In some cases, lower-quality hardware could lead to complications such as migration or failure, which could necessitate additional surgeries. Therefore, while cost is a consideration, it should not be the sole factor in your decision-making process.

2. Steel Screws vs. Absorbable Screws: The choice between steel screws and absorbable screws depends on various factors, including the specific nature of the injury, the surgeon's preference, and the expected recovery process. Steel screws are durable and provide strong fixation, which can be beneficial for immediate stability. However, they remain in the body permanently, which can sometimes lead to discomfort or complications later on. Absorbable screws, on the other hand, are designed to dissolve over time, which can eliminate the need for a second surgery to remove hardware. However, they may not provide the same level of initial stability as steel screws. The cost-effectiveness (CP value) of each option should be evaluated in the context of your specific situation, including the severity of the injury and your activity level post-surgery.

3. Returning to Football After Surgery: After ligament repair surgery, returning to high-impact sports like football is a significant consideration. Generally, it is advised to allow adequate time for healing and rehabilitation before resuming such activities. The timeline can vary based on the extent of the injury, the surgical technique used, and your individual healing process. Most athletes can expect a recovery period of several months, during which physical therapy will be crucial to regain strength, stability, and range of motion. It’s essential to follow your surgeon’s advice and not rush back into competitive play until you have fully recovered and received medical clearance.

4. Risk of Re-injury Post-Surgery: The risk of re-injury after ligament repair can be influenced by several factors, including the quality of the surgical repair, adherence to rehabilitation protocols, and the nature of the activities you engage in post-surgery. Studies indicate that while surgical repair can significantly improve stability and function, there is still a risk of re-injury, especially if the athlete returns to high-impact sports too soon or does not adequately strengthen the surrounding musculature. Engaging in a comprehensive rehabilitation program is crucial to minimize this risk.

In summary, when considering hardware for ankle ligament repair, it’s essential to weigh the pros and cons of different materials, prioritize quality over cost, and follow a structured rehabilitation program to ensure a successful recovery. Always consult with your orthopedic surgeon to discuss your specific case, as they can provide tailored advice based on your injury and lifestyle goals.

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