Treatment

Treatment is mainly conservative. A partially torn ligament may respond adequately to rest and analgesia. Completely ruptured ligaments and some partial tears may require cast immobilisation for 4-6 weeks. Healing occurs by fibrosis. However, the resultant scar tissue is weaker than the original and some mobility of the joint may be lost. Also, one can never be entirely sure of the extent of apposition.

Surgical repair may be advocated where:

• operation can proceed soon after injury whilst it is still possible to appose the torn ends
• the joint is markedly unstable
• the patient is young and active
• injury is to a weight bearing joint

The joint is immobilised post-operatively to relieve tension on the ligament. Gentle movements are encouraged after 3-4 weeks but the joint must be protected for another 4-6 weeks.