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Distorsion: Causes, Symptoms and Treatment

A distorsion is a joint injury caused by excessive stretching or twisting, damaging ligaments, tendons, or the joint capsule without fracturing the bone.

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Things worth knowing about "Distorsion"

A distorsion is a joint injury caused by excessive stretching or twisting, damaging ligaments, tendons, or the joint capsule without fracturing the bone.

What is a Distorsion?

A distorsion (commonly referred to as a sprain) is a frequent joint injury in which the stabilizing structures of a joint – particularly ligaments, the joint capsule, and surrounding tendons – are overstretched or partially torn due to a sudden, uncontrolled movement. The bony structures typically remain intact. The most commonly affected joints are the ankle, the knee, and the wrist.

Causes

Distorsions occur when a joint is forced beyond its normal range of motion. Common causes include:

  • Twisting or rolling the ankle while walking, running, or jumping
  • Sports injuries (e.g., soccer, basketball, skiing)
  • Tripping or slipping on uneven surfaces
  • Falling onto an outstretched hand (wrist injury)
  • Traffic accidents or sudden twisting movements

Grades of Severity

Distorsions are classified into three grades based on the extent of tissue damage:

  • Grade I: Mild overstretching of ligaments without tearing; minor swelling and pain.
  • Grade II: Partial tear of one or more ligaments with noticeable swelling, bruising, and reduced joint stability.
  • Grade III: Complete rupture of a ligament with severe swelling, possible bruising, and significant joint instability.

Symptoms

Typical signs and symptoms of a distorsion include:

  • Sudden, localized pain at the affected joint
  • Swelling and edema formation
  • Bruising (hematoma) around the joint
  • Warmth and redness of the skin
  • Restricted range of motion and pain on weight-bearing
  • Feeling of instability in the joint (especially in Grade II and III)

Diagnosis

The diagnosis of a distorsion is primarily clinical and may include:

  • Medical history: Description of the mechanism of injury and symptoms
  • Physical examination: Palpation, stability tests, and range of motion assessment
  • X-ray: To rule out a bone fracture
  • Ultrasound or MRI: For suspected significant ligament damage to assess soft tissue structures in detail

Treatment

Immediate first aid for a distorsion follows the RICE protocol:

  • Rest: Protect and rest the injured joint
  • Ice: Apply ice or a cold pack (not directly on the skin; max. 20 minutes)
  • Compression: Apply a compression bandage to reduce swelling
  • Elevation: Elevate the injured limb to promote lymphatic drainage

Depending on the severity, additional treatment measures may include:

  • Pain-relieving and anti-inflammatory medications (e.g., ibuprofen, diclofenac)
  • Stabilizing bandages, splints, or orthotic braces
  • Physiotherapy to restore mobility and joint stability
  • Surgical repair in cases of complete ligament rupture (Grade III) when indicated

Prognosis and Prevention

Mild distorsions typically heal completely within days to a few weeks. Severe injuries may require several weeks to months of rehabilitation. Preventive measures include:

  • Targeted muscle strengthening exercises to stabilize joints
  • Proprioceptive training (balance training)
  • Appropriate footwear and sports braces when necessary
  • Proper warm-up before physical activity

References

  1. Petersen, W. & Rembitzki, I.: Ankle Sprains – Pathophysiology, Diagnosis and Treatment, Open Access Journal of Sports Medicine, 2019.
  2. Kerkhoffs, G. M. et al.: Diagnosis, Treatment and Prevention of Ankle Sprains, British Journal of Sports Medicine, 2012.
  3. World Health Organization (WHO): International Classification of Diseases (ICD-11), 2022. Available at: https://icd.who.int

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