ligament

Ligament tear: Description

The ligaments are located around the joints. They stabilize, guide and limit joint movements. For this reason, ligament rupture (ligament rupture) affects the biomechanical function of the affected joint.

Band injuries are very common and are caused by a violent movement of a joint. Depending on the intensity of the trauma, this results in ligament distension, ligament tear or sprain (distortion).

In most cases a torn ligament is a sports injury. However, a ligament tear also occurs in other accidents, such as a fall or car accident. In sports, ligament injuries often occur in the ankle, knee, elbow, wrist and shoulder area.

classification

Torn ligaments are classified into a first- to third-degree injury, depending on the extent. This is important for therapy planning and prognosis. Most divisions use a first degree injury if the band is overstretched or torn ligament. A partial ligament rupture usually corresponds to a second-degree injury, and a complete ligament tear of the most severe injury (third degree).

Outside ligament

Everything important about the rupture of an outer ligament (such as at the ankle joint) can be found in the article outer ligament tear.

Interior ligament

Everything important about the rupture of an inner band (such as the ankle joint) learn in the contribution Innenbandriss.

Ligament tear – foot

You can read more about ligament ruptures in the foot area in the article Ligament Tear – Foot.

Torn ligament – knee

Learn more about ligament ruptures in the knee area in the article torn ligament – knee.

Torn ACL

Everything important about the rupture of a cruciate ligament on the knee can be found in the article cruciate ligament tear.

skier’s thumb

What is a ski thumb and how it is diagnosed and treated, read in the article Skidaumen.

Torn ligament: symptoms

Torn ligament symptoms are more or less specific depending on the type and severity of the injury. The sudden tearing of a tape may be accompanied by an audible sound (“crash”). The affected person experiences a sudden, severe pain, which in some cases can be localized to a specific area. The injured joint swells, the surrounding skin area may turn blue over the next few hours (bruise). If, for example, the outer band tears on the hock, you will almost always see a clear blue color. On the other hand, injuries to the knee rarely result in bruising under the skin.

The affected person can no longer properly burden the injured joint. A ligament injury may also be present if the injured person can still walk. Patients also often experience the feeling of “kinking away” and instability in the event of a torn ligament.

Cruciate Ligament Tear: Symptoms

Which symptoms causes a cruciate ligament rupture, read in the article cruciate ligament tear: Symptoms.

Torn ligaments: causes and risk factors

In general, joint movement beyond the normal range, which is forced by a high force, is the cause of torn ligaments. Thus, the cruciate ligaments or the inner ligament of the knee tear at very strong rotational movements or when overextending the knee. Often this happens when skiing or playing soccer.

The so-called ski thumb tears a sideband of the thumb base joint. This happens more often when skiing, when you throw your thumb on the slopes, or hang in a fall with your thumb in the loop of the ski pole.

Even in certain ball sports (especially in volleyball) it often leads to injuries of the finger joints as just a torn ligament.

The ligaments of the ankle are affected when bent over, for example when running or jumping (in tennis, football, basketball, etc.).

Other ligaments such as the posterior cruciate ligament tear especially in high-speed accidents in traffic. If a ligament tear affects the shoulder or wrist, it is often the result of a fall.

Risk factors for ligament rupture

Risk factors for ligament rupture include high-performance sport, poor training condition, certain sports, obesity, and previous injuries to the same joint, depending on the type of ligament tear. It is controversial whether gender also plays a role and women have a higher risk for certain types of torn ligaments or not.

Ligament tear: examinations and diagnosis

Specialists in the diagnosis and treatment of torn ligaments are orthopedists, accident surgeons and sports physicians. The suspicion of a torn ligament usually arises from the details of the accident and the description of the complaints, the doctor will ask the patient. He can ask questions such as:

• Can you describe the accident?
• Where is the pain localized?
• Are certain movements painful or difficult?
• Did you already have an injury in the affected area?
• Do you have pre-existing conditions?

After that, the doctor will examine the patient. He also takes care of swelling and malalignment in the injury area and checks blood circulation, motor function and sensitivity (DMS) of the joint. By palpation, the physician can pinpoint pain and pressure points, which often gives important clues to the affected band.

To assess the limitation of the ligament tear, the range of motion of the joint should be checked. On the basis of specific functional tests, the suspicion of a certain ligament tear can be confirmed. In some cases these examinations are not possible in the acute phase but because of the pain.

imaging

In unclear cases or to clarify additional injuries (such as on the bone), imaging techniques are used. You can choose between different methods.

Experienced physicians will benefit from the ultrasound examination of the joint, which can be performed without radiation exposure.

An X-ray image is made especially in suspected additional bony damage next to the ligament tear or a bony ligament tear. Indirectly, however, a torn ligament can also be detected on an X-ray image, which is especially true for the so-called “stress recordings”. The affected joint is held in certain positions during the recording.

Particularly suitable for imaging a ligament tear is magnetic resonance imaging (MRI). It gets along without damaging rays.

Ligament tear: treatment

The acute treatment of ligament rupture (or suspicion) is based on the PECH rule: break, ice, compression, high-altitude storage. Ice (cryotherapy) or cold water can be applied every two to three hours for 20 minutes each. The compression of the affected area should begin as soon as possible: If possible, apply a pressure bandage to the affected joint to counteract swelling. When storing high, make sure that the affected area is as high as possible above the heart level.

If necessary, patients can take a painkiller. Particularly suitable are so-called non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. The knee joint should also be protected from further injury. These measures should be continued for about three days so that inflammation and swelling are stopped. To give the foot rest, crutches should be used until a normal gait is possible.

Treatment at the doctor

Torn ligaments are treated either conservatively or surgically. Whether an operation is necessary depends on many factors such as the type and severity of the injury (partial tear or complete tear) and the biomechanical limitation of the affected joint. Also, age, activity and not least the wishes of the patient are taken into account in the treatment planning.

Conservative treatment

With a ligament strain and a slight torn ligament, it is usually sufficient to stabilize the joint for some time by bandages. The symptoms should disappear within about two weeks. During this time, the joint may indeed be charged, but should not be exposed to full (athletic) load. Because the risk of a renewed injury to the overstretched ligaments is too great in the early stages.

Decisive for a successful healing process and a good biomechanical joint function is the early start of physiotherapy. In addition to pure muscle training to promote joint guidance, good coordination training is also important. This is done, for example, the tilt-board or wobble board in band injuries in the ankle area.

A stabilization of the joint with special bandages or orthoses may also be useful.

Operative treatment

An operation may be necessary for a variety of reasons. In most cases, only a higher-grade torn ligament is operated on. The benefits of surgery are often stated to reduce the chance of chronic pain and better repair of joint stability.

In certain types of ligament rupture, surgery is considered the drug of choice, such as cruciate ligament tears in the knee joint. Fresh injuries can be stitched and the cruciate ligament is additionally reinforced by a piece of the body’s own tendon. For older tears, the cruciate ligament is replaced by a piece of tendon (cruciate ligament plastic). Also, a ski thumb should be operated on within a short time to get the full function of the hand. A bony ligament tear (tearing of the tape on the bone together with a bone fragment) is usually also operated and then usually made quiet for several weeks.

In addition to the severity and nature of the injury, other factors also play a role in the decision for or against surgery. Competitive athletes have a specific requirement profile for the affected joint. For this reason, in competitive athletes depending on the extent of the injury torn ligaments are often put together and surgically sutured.

Also, before and after an operation, the physiotherapeutic accompaniment is very important as with a conservative treatment. For joint stabilization, a torn ligament splint can be prescribed after surgery.

Cruciate ligament tear: Op

Everything important about the surgical treatment of this ligament tear can be read in the article Cruciate ligament tear: Op.

Ligament tear: Disease course and prognosis

In most cases, a ligament tear prognosis is good if the injury is treated early and correctly. In particular, a good planned physiotherapy is crucial for the success of the treatment. However, the prognosis also depends on the affected band, the severity of the injury and other factors, so that no general statements can be made. Also, the question of when the patient can return to full activity, can not say blanket. The healing process of ligament rupture can last from a few weeks to a few months.

Prevent torn ligaments

If you want to prevent torn ligaments, you should especially train and strengthen those muscles that support particularly stressed joints (such as the ankle joint, knee joint). For risky exercise, you can use bandages as extra support. In addition, you should warm up before exercise.

Ligament tear: Consequences if no treatment

If a torn ligament is not treated, long-term consequences such as frequent buckling, disturbed joint function and chronic pain of the pain threaten. It also increases an untreated ligament the risk of osteoarthritis.