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A devastating injury to a young rugby player

Repairing the juvenile ankle

Adolescents and young adults require a specific approach

When treating adolescents and young adults, it’s important to recognise that they’re not just smaller versions of adults. Their bones are still growing, their ligaments behave differently, and their recovery potential is high, but so are the risks if injuries are missed or mismanaged. Of course, knowing they are more likely to want to return to the same level as before the injury can be one of the biggest challenges.

In sport-playing teenagers, particularly in contact sports like rugby, ankle injuries can be more complex than they first appear. Early and accurate assessment is key to taking the appropriate next steps and protecting the joint long-term while always considering the strong desire to get them back to doing what they love safely.

The patient & the injury

A 15-year-old regional-level youth rugby player (and all-round sports person) damaged his ankle while playing a game in the Yorkshire area. The injury happened on the 6th October 2024 and was an innocuous fall during a lineout. 

In the video you can hear from the video the distress from the player and the parent, which is a big part of these injuries, and Mark, being a father of 3, has great understanding for both child and parent. 

The MRI of the injury showed the following conclusion;

  • Large Osteochondral defect from the lateral shoulder of the talar dome, which has rotated approximately 180 degrees about it longitudinal axis.
  • Bone oedema within the sustentaculum talus, but no completed fracture.
  • The anterior talofibular ligament ruptured.

The cartilage repair surgery

Mark listed the young patient for surgery, from the injury that happened on the 6th October, he was operated on the 16th.  The broken cartilage fragment was fixed back into place, and the ligament (ATFL) was surgically repaired to restore full function and stability in the ankle joint.

1. Defect preparation and locating the broken fragment.

2. Cartilage fragment removed from the joint space.

3. This is what the corner of the talus ankle bone looks like!

4. Prepared and pinned back into place in the ankle.

5. No more defect, giving back the stability to the ankle.

6. Ligament (ATFL) repair to ensure full stability is returned to the joint. 

Mark is one of the North East & Yorkshire’s most experienced cartilage repair surgeons and can carry out complex cartilage repairs through a mini-incision like the one we can see here. The importance of this is causing much less damage to the surrounding soft tissue and improves recovery, of course, without compromising the actual repair.  Once completed, Mark will check his ankle through its natural range of motion and that the repair stays in place. 

The recovery

The young gentleman’s recovery has been excellent. The image of his ankle was taken 1 month after surgery, and he has healed very nicely and neatly, one of the advantages of the mini-open techniques.

He is also back to enjoying non-contact sport, training and being active and plans to return to the competitive rugby field soon. As you can see from the video, his father kindly sent us of him enjoying golf 8 months after surgery, he certainly seems to have plenty of strength and flexibility in his ankle.

If you, or a younger member of your family, have injured their foot, ankle or knee, Mark would be delighted to see you at his private clinics in Leeds Nuffield, or Duchy Circle Health, Harrogate. He also works in the NHS at Harrogate District General. 

Contact Mr. Farndon