Sprains

A sprain is a complete or incomplete tear of the supporting ligaments surrounding a

joint. It usually follows a sharp twist.
An immobilized sprain may heal in 2 to 3 weeks without surgical repair, after which the
patient can gradually resume
normal activities. A sprained ankle is the most common joint injury, followed by sprains
of the wrist, elbow, and knee.
Causes
Causes of sprains include:
sharply twisting with force stronger than that of the ligament, inducing joint movement
beyond normal range of
motion
concurrent fractures or dislocations.
Pathophysiology
When a ligament is torn, an inflammatory exudate develops in the hematoma between
the torn ends. Granulation tissue
grows inward from the surrounding soft tissue and cartilage. Collagen formation begins
4 to 5 days after the injury,
eventually organizing fibers parallel to the lines of stress. With the aid of vascular
fibrous tissue, the new tissue
eventually fuses with surrounding tissues. As further reorganization takes place, the
new ligament separates from the
surrounding tissue, and eventually becomes strong enough to withstand normal muscle
tension.
Signs and symptoms
Possible signs and symptoms of sprain are:
localized pain (especially during joint movement)
swelling and heat due to inflammation
loss of mobility due to pain (may not occur until several hours after the injury)
skin discoloration from blood extravasating into surrounding tissues.
Complications
Possible complications of sprain include:
recurring dislocation due to torn ligaments that don't heal properly, requiring surgical
repair (occasionally)
loss of function in a ligament (if a strong muscle pull occurs before it heals and stretches
it, it may heal in a
lengthened shape with an excessive amount of scar tissue).
Diagnosis
Sprain may be diagnosed by:
history of recent injury or chronic overuse
X-ray to rule out fractures
stress radiography to visualize the injury in motion
arthroscopy
arthrography.