你需要踝关节手术吗？

When you rely on your feet to carry you through your favorite sport, the idea of an ankle surgery (even to treat a painful injury) can be scary. Unfortunately, ankle injuries can be common in athletes, and sometimes, ankle surgery is the best treatment option. A sprained ankle, for example, is the most common injury in sports. Other common ankle injuries include a stress fracture, broken ankle and overuse ankle tendon injuries (known as tendinopathies), says格里高利Waryasz医学博士,二者，体育医学专家在大众普通广场beplayer下载foot and ankleorthopaedic surgeon at Massachusetts General Hospital.

无论你的脚踝受伤是什么，你需要康复完成一件事：到get you back in the game尽快。Depending on your unique situation, that may or may not mean ankle surgery.

"You try something, patients often feel a little better, but then the pain comes back. At that point, you either try the same treatment again to see if the injury settles down, try a new treatment or you jump into surgery."

3 Factors That Determine If You Need Ankle Surgery

1.受伤的类型

好消息是，大多数脚踝受伤不需要手术，因为许多脚踝受伤很小，就像脚踝扭伤一样。然而，当受伤变得更严重时，脚踝手术变得越来越可能。例如，踝关节肌腱疗法（过度使用导致踝关节疼痛，肿胀和僵硬）通常可以通过休息和物理治疗来愈合。但如果你的脚踝肌腱或韧带实际上是泪水，你可能需要脚踝手术以完全恢复。同样，踝骨骨折可以用脚踝支撑，靴子或铸造，但是脚踝骨折，脚踝骨折或涉及脚内的多于一根骨骼可能需要插入脚踝手术，插入销或螺钉以保持骨骼，肌腱和韧带的位置。

2.运动或选择的运动

Sometimes, your sport or activity of choice is what determines if ankle surgery is a good idea, says Dr. Waryasz. For example, hockey players can sometimes potentially skate with a minor ankle fracture or bone bruise in their foot. However, if you play a running-heavy sport like soccer, playing with a foot or ankle fracture may be too painful and could cause further damage. A foot or ankle injury may not be safe to play on and your doctor can explain why that is. In cases like this, foot or ankle surgery might be wise, so talk through your options with your doctor.

3.治疗历史

If you've been dealing with your injured ankle for a while now and still have foot or ankle pain and or swelling, you may need ankle surgery to prevent further bone, tendon, or ligament damage. Or, if you keep experiencing the same type of ankle injury over and over again, chances are you need to switch up your treatment approach.

"That's part of the normal process of conservative care. You try something, patients often feel a little better, but then the pain comes back," Dr. Waryasz says. "At that point, you either try the same treatment again to see if the injury settles down, try a new treatment or you jump into surgery."

Ladder of Ankle Treatment Options

Regardless of how you've injured your ankle, there are different levels of treatment to consider. The first line of treatment may work for 80 percent of patients, but if it doesn't resolve your issue, you often have other options before surgery, says杰里米·史密斯，MD，体育医学专家在大众普通广场beplayer下载and foot and ankle surgeon at Brigham and Women's Hospital.

Here are several types of treatment options available, listed from the least to most invasive:

第1步：休息

Giving your ankle a short break from sports can be just what it needs to feel better. How long you rest may vary depending on your injury and sport, so seek guidance from your doctor, physical therapist or athletic trainer. (See ankle injury prevention)

Step 2: Physical Therapy

Performing flexibility, mobility and strengthening exercises can help ease ankle stiffness and any weaknesses that may contribute to your foot pain or ankle instability. Your doctor may recommend rest in addition to physical therapy, or you may be able to do physical therapy while still participating in your sport. Check with your care team to figure out what's right for you.

Step 3: Medications and Injections

如果休息和物理治疗不够，如果您可以转向抗炎和缓解疼痛的药物。根据史密斯博士的说法，这可以包括类似于布洛芬的抗逆端非甾体抗炎药（NSAID）以及办公室内酮注射。矫形剂注射选择也可用于治疗。

Step 4: Extracorporeal Shockwave Therapy (ESWT)

This procedure delivers low-energy shockwave impulses to injured tendons to stimulate healing. Because it's noninvasive, doctors may try ESWT before recommending surgery.

Step 5: Surgery

当所有其他人失败时，手术可能是您最好的选择。在考虑脚踝手术时，始终与一家专门从事脚踝受伤的外科医生，并有经验帮助自己等运动员。