Difference between a sprain and broken ankle: The request could not be satisfied
How to Tell If Your Ankle Sprained or Fractured
No matter how they happen, ankle injuries can be very painful. They can also be slow to heal due to their location. Because of this, it’s important to know which specific injury you have so it can be properly treated from the onset. How can you tell the difference between an ankle sprain and a fracture?
What is an ankle sprain?
An ankle sprain is a ligament injury that occurs when the ligament is stretched or twisted into an awkward position, like stepping in a hole or missing a step. The ankle is the most common location for a sprain, and the severity ranges from Grade 1, which includes only a light stretch or tear, to Grade 3, which is a complete tear that may require a cast or even surgery.
Treatments for a sprained ankle
Sprains include bruising, swelling, tenderness, pain with walking, and sometimes the inability to walk at all. Immediately after the injury, use the RICE method — rest, ice, compression and elevation — along with anti-inflammatory medications to reduce pain and swelling. Try to keep your ankle above your chest as much as possible for at least 48 hours, and use ice in 15-20 minute intervals several times a day.
Sprains may seem minor, but if left undiagnosed and untreated they may end up leading to more serious complications and long-term issues such as arthritis. It’s always a good idea to have your injury checked out by a doctor, especially if your ankle is still very swollen after 24 hours, misshapen, or if it hurts when you press on the bony part of your ankle.
What is a fracture?
A fracture is the same thing as a “break.” Much like sprains, breaks can vary — from hairline fractures that only involve one bone to multiple, compound fractures that keep you off your foot for months. Like sprains, fractures usually happen because of extreme force on the bone, either from a fall, auto accident, or other acute-force trauma.
How can you tell the difference between a sprain and a fracture?
It’s very hard to determine whether your ankle is badly sprained or fractured. Many times, a fracture causes the complete inability to bear weight, or move the ankle or toes. However, it can also feel and look very much like a Grade 3 sprain, so it’s important to see a doctor for the correct diagnosis. Treatment options usually involve casting, booting, and sometimes surgery.
While these are some of the most common ankle injuries, there may be other reasons you’re experiencing pain. Trust the team of experts at Alexander Orthopedics to determine the cause of your pain and get you back on your feet as quickly as possible.
Broken or Sprained Ankle? – Pontchartrain Orthopedics & Sports Med
The ankle has an ant-like ability to sustain huge loads during day-to-day life. In fact, it can handle up to three times a person’s body mass. But when things go wrong, the results can be painful and difficult to diagnose. How do you know if you have a broken or sprained ankle?
Anatomy of the Ankle
Understanding the difference between a broken or sprained ankle starts with understanding the anatomy of the ankle. The joint is made up of three bones, the inside and back part of the tibia (or shinbone), the end of the fibula (a smaller, lower-leg bone), and the talus (a small bone that sits between the heel, and the tibia and fibula).
The inside portion of the tibia is known as the medial malleolus. The back of the tibia is the posterior malleolus, and the end of the fibula is called the lateral malleolus. Doctors classify fractures based on these official titles. For example, a break at the end of the fibula is called a lateral malleolus fracture.
Diagnosing a Broken or Sprained Ankle
“The anatomy of the ankle is very complex, and the pain from a broken or sprained ankle can be quite similar,” says sports medicine specialist Dr. Joseph L. Finstein. “I’ve diagnosed patients with a break and sprains following identical mishaps – A trip or fall, twisting or rolling an ankle, or an impact in sports.”
The diagnosis process begins with a careful examination of your ankle, foot and lower leg with a focus on pain levels, how the injury happened, and your medical history. If an ankle fracture is indicated, additional tests like X-rays, CT (computed tomography) or MRI (magnetic resonance imaging) scans, or stress tests may be ordered to provide more information.
“The anatomy of the ankle is very complex,
and the pain from a broken or sprained ankle can be quite similar.”
– Dr. Joseph L. Finstein, MD
Is My Ankle Broken?
Broken ankles are caused by stressing the ankle joint beyond the strength of its elements. When a fracture occurs, the bone is chipped, cracked, or completely broken in two or more places.
Symptoms most associated with a broken or sprained ankle may include:
severe and immediate pain
ankle is tender to the touch
Breaks should always be checked by a healthcare professional to ensure proper healing. As Dr. Finstein discussed in his blog post “Broken Bone – Why See an Orthopedist”, an untreated break can lead to serious complications. The fibula, for instance, can be fractured at different levels, each requiring different treatment options.
Diagnosing an Ankle Sprain
A sprained ankle is actually a tear or disruption of the ligaments, which is fibrous tissue that holds bone to bone in a joint. Sprains occur when too much pressure is put on the joints, overstretching the ligament to the point where they can rupture completely.
Spains are generally broken down into two types: a common ankle sprain and a high ankle sprain. The common variety involves an injury to the AFTL (anterior talofibular) ligament on the outside of the ankle. A high ankle sprain, which is quite common in sports, involves a different group of ligaments above the join and between the tibia and fibula, known as syndesmosis.
New Orleans Saints running back Alvin Kamara suffered a high-ankle sprain during practice after a Week 6 game against the Jacksonville Jaguars. University of Alabama quarter Tua Tagovailoa endured a similar injury earlier this season.
Treating a Sprained Ankle
As with broken or sprained wrists, most ankle sprains are treated using the “RICE” method of rest, icing, compression and elevation. Patients are encouraged to keep weight off the affected joint, to ice for about 15 minutes every few hours during the first days after injury, to wrap the leg, and to sit or lie with the foot above the level of your heart. This helps reduce swelling and alleviate some pain. The period of rest for a high ankle sprain can be as much as twice as long – six weeks or more.
In the case of severe high ankle sprains, if the ankle is unstable, a fracture is out of place or the ligament is completely torn, surgery may be required. The latest surgical treatment to stabilize a high ankle sprain is the TightRope anchor system. The TightRope system anchors the ends of the tibia and fibula together with a braided polyethylene cord, rather than with a rigid surgical screw, to restore the original position of the bones and to allow for proper healing.
Healing after these injuries involves a similarly broad range of time. Pain from some sprains is gone within a matter of weeks; it takes longer for broken bones and torn soft tissue to heal. The doctor may recommend a walking boot, as you transition back to every-day activities.
How to Evaluate a broken or sprained ankle
Because a broken and sprained ankle can be so similar, you need to have an ankle injury evaluated by a specialist. If the injury happens on the weekend, you can see an orthopedic specialist, without an appointment, at our Saturday clinic. We see patients on both sides of the river at our Metairie clinic and our Boutte clinic.
How to Tell the Difference Between an Ankle Break and a Sprain
With the warm weather enticing you to join the outdoors and frolic through summer, injuries are bound to happen, even to your unsuspecting ankles. From seasonal sports to harmless gardening, an ankle injury can emerge from any number of situations, including:
- A motor vehicle accident
- Tripping over something or falling awkwardly
- Twisting, rolling or rotating the ankle in an uncomfortable way
When an unsuspecting ankle injury occurs, knowing what kind of ankle injury will play a pivotal role in getting you back on your feet. To determine whether your ankle is broken/fractured or sprained depends upon whether you damaged the bone or the tissue. Let’s decipher how to tell the two apart…
Sprain Versus Fracture
Ankle Sprain: When a sprain occurs, one or more of the ligaments in the ankle become severely overstretched or even torn. (A ligament is a fibrous tissue that helps hold the ankle together.)
Ankle Fracture: A fracture is a break in a bone. With regards to the ankle, the bones that make up the top ankle joint are typically the most prone to fracture. These include the shinbone (tibia), the anklebone (talus) and the bone of the lower leg (fibula).
With definitions in tow, determining which ankle injury you’ve suffered can be tricky at best. Here are a couple of questions to consider after injury has occurred:
- Does the pain seem to radiate from the soft tissues surrounding the ankle but not over the bone? It’s probably a sprain.
- Is the pain over the anklebone? That may be an indication of a break.
- Are you unable to put pressure on it or walk? It is possible that the ankle is broken.
If the injury is still unclear or if you are hesitant to rush to the doctor, it may not hurt to carefully observe and lightly treat the injury utilizing the R.I.C.E. method of treatment and assessment:
- Rest the ankle
- Ice the ankle to reduce swelling and pain
- Compress the ankle with an air cast or bandage wrap to stabilize and immobilize the ankle
- Elevate the ankle until it’s level with the heart to help decrease pain and swelling
If, after two to four days of the R.I.C.E. method, you still have a hard time moving or putting pressure on the ankle, a visit to an orthopedist is in order. This is also true if dark blisters or bruises have developed. Once the orthopedist diagnoses the injury, treatment can begin.
Treatment for a Sprained Ankle
Treatment for a sprained ankle depends on the severity of the injury, which can be graded as mild (Grade I), moderate (Grade II) or severe (Grade III):
- Mild sprains are typically healed utilizing the R.I.C.E. method combined with range of motion, strengthening and stretching exercises.
- Moderate sprains are also treated with the R.I.C.E. method, but for a longer period of time. A physician may use a soft cast or a splint to immobilize the ankle and prescribe range of motion, strengthening and stretching exercises. Physical therapy may also be suggested to restore full motion and use of the ankle.
- Severe sprains are a full tear or rupture of a ligament. When this occurs, the ankle must be fully immobilized and requires a longer period of physical therapy. In some cases, surgery may be required to repair the tear.
Treatment for a Broken Ankle
Fractures may be treated surgically or non-surgically depending on the injury. If the ankle is stable, only one bone is broken and the bones aren’t out of place, the ankle may simply be immobilized with a splint or cast.
However, if the ankle is unstable, surgery is required to reinforce it. During the procedure, a metal plate and screws are used to hold the bones in place. Then, the ankle is positioned in a splint. Once the swelling goes down, a cast is utilized for several weeks as the ankle heals.
It is important to remember that, regardless of whether you suspect a sprain or a break, if often requires an orthopedist to accurately diagnose your condition.
Comprehensive Ankle Care
At NEOSM, our physicians have years of experience in effectively treating all orthopedic conditions and injuries, including those of the foot and ankle. Our multidisciplinary approach to care ensures that patients receive the customized treatment they need to get moving again.
For more information on ankle injury or to schedule an appointment with one of our specialists, contact NEOSM today.
Sprain or break? Signs and symptoms to look for in your kids
After a summer full of events, and with the start of the fall sports season, it might seem like your kids never stop moving. Plus, with all of these activities, the occasional injury is sure to follow.
But when an injury does occur, how can you identify the source of the pain and get the right help?
“Two of the most common injuries children face are sprains and broken bones,” said Dr. Todd Holmes, director of Geisinger South Wilkes-Barre Emergency Medicine. “And though these are two totally different issues, it can sometimes be hard to tell them apart.”
Sprains are caused by the excessive stretching or tearing of the ligaments, which are strong bands of tissue that surround your joints and bones and help you move. The most common type of sprain is a sprained ankle.
“Many of us have experienced a twisted ankle, whether it is from a fall or sudden movement playing sports,” said Dr. Holmes.
Broken bones are very common with thousands of cases each year, but are often a much more severe injury.
“Our bones are strong and a bit flexible, but with enough pressure they will still break—similar to a tree branch,” said Dr. Holmes.
The difference between a sprain and a break
Though it may hurt like a broken bone, a sprain doesn’t damage your bones or joints. Your child may have heard a “pop” when the injury occurred, and is now experiencing pain, swelling, bruising and decreased movement but they are still able to control the body part and don’t appear to be bleeding.
On the other hand, broken bones can take a variety of different forms. Many are marked by a deformity, where the limb looks out of place. In severe cases, the bone can pierce the skin. This is called a compound fracture. Movement with a broken bone is often extremely difficult or painful.
“In the case of a stable fracture, the bone will be broken but remain in place, so you may not be able to tell the bone is broken just by looking at it,” said Dr. Holmes.
You can treat minor sprains at home by elevating the limb and applying ice to decrease inflammation. You may also want to give your child a pain reliever like acetaminophen. In more serious cases, your pediatrician may recommend a splint or brace.
However, if you’ve iced and elevated the limb for a day or two and the swelling hasn’t gone down, it might be time to call your doctor, who may recommend an X-ray, or a trip to the emergency room or an urgent care center that’s equipped with X-ray.
“Though a bad sprain could mean your child’s joint stays swollen for several days, you’ll likely want to check with your doctor after a day or two if you’re not seeing in improvement in it,” said Dr. Holmes.
Tests may prove that your child actually broke a bone and should be treated immediately.
In most cases, the limb will be placed into a cast to immobilize the bone or a brace that allows minimal movement of nearby joints after confirmed the break with an X-ray. Traction, the process of realigning bones through gentle pulling, or external fixation, a surgical procedure where metal pins or screws to stabilize the bone, may also be needed for severe fractures.
“Getting medical treatment quickly is vital for broken bones,” said Dr. Holmes. “Continuing to use a broken bone can cause the break to worsen. The pieces may move further from one another or the sharp edge of a broken bone can pierce tissue.”
Even minor untreated fractures can lead to chronic pain down the line, as your ligaments are forced to accommodate bones that may not be straight.
Todd Holmes, MD, is an emergency medicine physician at Geisinger South Wilkes-Barre.
Sprain, Strain or Break; how do you tell the difference? – Spokane Orthopedic Care
Posted on January 27, 2015 by OSC
If you’ve ever sprained your ankle, stubbed your toe, or bumped into an unseen object in the dark, then you know how bad minor injuries can hurt. Sometimes we walk it off and move on. Other times the swelling doesn’t come down and mobility decreases, and that’s when you might wonder if its time to see a doctor. So how do you tell the difference between a break, sprain or strain?
Sometimes, a sprain can be even more painful than a break. A sprain is caused by trauma that overstretches ligaments and puts stress on a joint. A mild sprain is where the ligaments are stretched but the joint remains stable, while a moderate sprain is where the ligaments are slightly torn, making the joint unstable. In some cases the sprain is so severe that the ligaments tear away from the bone, making the joint unable to function.
A strain is different from a sprain in that it’s brought on by repetitive use rather than trauma. A strain affects the muscles and ligaments but has less to do with joint function. Common strains are in the lower back and hamstrings, especially in athletes.
Although severe breaks may be obvious, such as a bone protruding from the skin, or a popping or grinding sound during the injury, fractures can be hard to determine until you get a proper x-ray from your doctor. Most breaks will be accompanied by pain and swelling. If the pain increases as you put weight on the injury, and mobility becomes restricted due to inflammation, you are most likely dealing with a break or fracture. A break should always be treated by your doctor so the bone can heal properly.
For mild sprains and strains that don’t require medical attention, use the RICE method:
Rest: rest the affected area by moving it as little as possible, giving it a chance to heal.
Ice: apply an ice pack wrapped in a towel immediately to the injury in 15 minute intervals and repeat 3-4 times daily. This will help to reduce inflammation.
Compression: wrap the affected area tightly, but not so tight that blood flow is restricted. A pressure bandage works best.
Elevation: raise the injured area above the level of your heart, which will increase blood flow and promote faster healing. Laying down, you can easily prop up a leg or elbow.
Although it is good to have the knowledge to treat minor injuries, if there is any question about the severity of a sprain, strain or break, make an appointment with your doctor immediately for an x-ray. ‘Toughing out’ a break may lead to incorrect healing and much bigger problems down the road.
Broken Bones, Dislocations, Sprains and Strains
The Urgency Room
Filling the gap between crowded emergency rooms and doctor appointments you have to schedule far in advance is The Urgency Room. Our three standalone locations in Eagan, Woodbury and Vadnais Heights are your convenient solution to urgent medical needs around the Twin Cities. From Minneapolis to St. Paul, The Urgency Room is well-equipped with state-of-the-art equipment to help you with a vast range of medical needs.
Whether you’ve been experiencing some lingering symptoms or you have obviously urgent medical needs, The Urgency Room is your perfect solution. Open 365 days per year, including holidays, from 8:00 AM to 10:00 PM, we are a convenient medical care option for when you need it most. While your typical emergency room is crowded and laden with illness, germs and long waits, your experience with The urgency Room will open up an entirely new world of urgent care for you.
You can always see how short of a waiting time exists at your preferred location by checking our real-time wait trackers. Our friendly staff is standing by for when you need medical care fast—especially for when you have broken bones, dislocated joints, and sprains or strains.
What’s the difference between broken bones, dislocations and sprains/strains?
If you’ve ever experienced one or all of these medical situations, you may be aware of their individual telltale signs. However, there are many times when it may be difficult to determine if a bone is broken or if you have a sprain or strain. Broken bones, dislocations and sprains/strains may have similar symptoms such as soreness, swelling and inability to function as you normally would with that afflicted body part. However, these are completely different injuries that require urgent care and specific attention.
When a bone is broken
Whether it’s called a break or a fracture, it’s a broken bone. However, it isn’t that simple. While bones allow some flexibility, they are still rigid. When bent or impacted beyond its flexibility, a bone will break. There are different types of break and the severity usually depends on the type and extremity of the impact the bone endured.
Different types of breaks include:
– Stable fracture: A bone that is broken so that the broken ends are still aligned
– Open, compound fracture: When the broken bone pierces the skin and may or may not be visible in the wound
– Transverse fracture: A broken bone that has a horizontal fracture
– Oblique fracture: A broken bone that has an angled fracture
– Comminuted fracture: A broken bone that has shattered into three or more pieces along the fracture
Your bones exist to give your body structure—they hold you up, help you function and protect your organs. It’s no wonder they’re incredibly strong. It’s estimated that a rib bone can withstand up to 740 pounds of force while the average femur can take nearly 900 pounds of force. While these are solid estimates, the amount of force your bones can endure before breaking relies on several factors such as:
- The type and severity of trauma it experienced
- If you have a pre-existing condition that weakens bones such as osteoporosis
- Overuse often leading to stress fractures
When you break a bone for whatever reason, you may experience symptoms such as swelling, bruising or deformity if the break is severe enough that it has shifted portions of your body. Most commonly, a suspected break will be examined via X-ray. More serious or difficult to see breaks, though, may require magnetic resonance imaging (MRI).
Treatment for a broken bone varies depending on the break, its severity and where it’s located on your body. Many breaks or fractures require a cast—whether it be plaster or fiberglass—that will hold the broken pieces together and allow new bone to “knit” the ends back together. In severe cases, broken bones will need to be fixated while healing through the use of metal plates and screws applied either internally or externally.
It can take anywhere from several weeks to several months for broken bones to heal. To help prevent them altogether, it’s a good idea to improve your diet and increase your exercise. By building muscle, you’re increasing the strength of your bones, thus helping prevent further or more serious breaks in the future.
While breaks can happen at the end of a bone, on a joint or somewhere in between, dislocations can occur only at joints. A dislocation is an injury that causes the ends of your bones out of position within a joint. Common dislocations include ankles, knees, shoulders, hips, elbows, fingers and even your jaw.
Don’t hesitate when it comes to dislocated bones. Not only is a dislocation generally very painful, but it can also cause further damage to nerves or tendons if not addressed immediately. Your nearest Urgency Room is equipped to care for you and treat your dislocation in the best way possible in the least amount of time.
Symptoms of a dislocated bone may include swelling, bruising and pain. When a dislocation occurs, you’ll often be able to see the bone “out of place.” Once you come to the Urgency Room, our experienced physicians will be able to assess the severity of your dislocated bone and treat it accordingly.
Dislocation treatment may include repositioning the bone in the joint, a prescription for painkillers or anti-inflammatories, a sling or a splint, and possible rehabilitation treatment. If your dislocation is severe, it may take longer than the usual 2–3 weeks to return to full movement. After dislocating a bone, however, be wary as that bone is more prone to dislocation in the future. Many athletes who dislocate knees or ankles may wear special supports or elastic braces in the future to prevent additional dislocations.
What is a sprain/strain?
A break is a broken or fractured bone, a dislocation is when a bone moves out of its joint, and a sprain/strain is the stretching or tearing of ligaments or tendons. While they may seem similar enough, a sprain and a strain are two different injuries.
Sprain: A sprain involves the ligaments, otherwise known as the fibrous tissues that connect two bones together in your joints.
Strain: A strain is the stretching or tearing of the tendons, otherwise known as the fibrous tissues that connect your muscles to your bones.
Both a strain and a sprain are commonly less severe injuries than breaks or dislocations. However, a trip to the Urgency Room is still a good idea to rule out any fractures or breaks that could cause further pain and damage if left untreated. Also, if a sprain or strain is severe enough, surgery may be required to repair extremely damaged ligaments or tendons.
The usual treatment after getting your sprain or strain assessed is R.I.C.E. or rest, ice, compression and elevation. With proper care and diagnosis by your local Urgency Room physician, your sprain or strain should dissipate in a few weeks, leaving you good to go and back on your feet.
Whether you live in Minneapolis, St. Paul or anywhere around the Twin Cities, heading to your nearest Urgency Room when you need medical attention is the cost-effective solution that could save you valuable time. Call or stop by one of our three locations any time to learn more or experience the best urgent care available.
If you’d like to see all that our state-of-the-art facilities offer, take our virtual tour or peruse the types of equipment we offer or the variety of ailments we can diagnose and treat on-site. And once you leave our facilities, the care doesn’t stop there. The Urgency Room has put together a large video library of after-care and at-home videos for your personal use. At The Urgency Room, your care is our priority.
Sprained Ankle | Strained Ankle | Ankle Injuries & Fractures
What causes ankle pain?
Dr Sarah Jarvis MBE
For most of our evolution, animals with a backbone and skeleton (vertebrates), such as human beings, have walked on four legs. When we evolved to walk on just two legs the ankle was given a lot of extra work to do, both in weight bearing and in balance. It’s perhaps not surprising that the ankle is prone to being sprained or broken.
A sprain is an injury to the band which connects two or more bones to a joint. This band is called a ligament. A sprain is usually caused by the joint being forced suddenly outside its usual range of movement. Most sprains heal within a few weeks. A severe sprain may look and feel like a fracture, and it can be difficult for health professionals to tell the difference between the two. A sprained ankle is the most common sports injury. To read more about different types of sports injuries, see the separate leaflet called Sports Injuries. To find out more about sprains, see the separate leaflet called Sprains and Strains.
A fracture is a break in a bone. A broken ankle means one of the bones which make up the ankle joint has broken. These are the leg bones (the tibia and fibula) and the hindfoot bones (the calcaneus and talus). Depending upon the exact cause of the fracture, one or more bones may be involved. Fractures cause sudden pain and usually cause significant swelling. Stress fractures are smaller cracks in the bone which also cause intense pain but with less dramatic swelling.
This leaflet considers ankle sprains and ankle fractures. Ankle pain may arise from many other conditions, including arthritis, gout or Achilles tendinopathy. You can read more about these in the separate leaflets called Arthritis, Gout and Achilles Tendinopathy.
Anatomy of the ankle
As you can see from the picture below, showing bones and ligaments of the ankle, it is a complicated joint. The top illustration shows the foot and ankle looking from the inner side (medial). The bottom illustration shows the foot and ankle looking from the outer side (lateral).
What is a sprain?
A sprain is an injury to a ligament. Ligaments are strong band-like structures around joints, which attach bones together and give support to joints. A ligament can be injured, usually by being over-stretched. Some of the fibres of the ligament will then tear.
A damaged ankle ligament causes inflammation, swelling, and bleeding (which shows as bruising) around the affected joint. Moving the joint is painful. The picture below shows a badly sprained ankle with lots of bruising.
The severity of a sprain is graded according to how badly the ligament has been damaged and whether or not the ankle joint has been made unstable. The joint can become unstable when the damaged ligament is no longer able to give it the normal support:
- Grade I – mild stretching of the ligament without joint instability.
- Grade II – partial tear (rupture) of the ligament but without joint instability (or with mild instability).
- Grade III – a severe sprain: complete rupture of the ligament with instability of the joint.
Lateral ankle sprain
- The most common ligaments to damage when you sprain your ankle are the ones on the outer side of the ankle joint (a lateral sprain): the anterior talo-fibular ligament and the calcaneo-fibular ligament (lateral ligaments).
- The lateral ligaments can stretch and be sprained when you ‘go over’ on your ankle and your foot turns inwards under you and points downwards.
- Sometimes you can break a small bit of bone off the very end of the fibula (where the ligaments are attached) at the same time. This and other types of ankle fractures are discussed below.
High ankle (syndesmotic) sprain
- It is much less common to damage the ligaments that attach across the ankle on the inner (medial) side of the foot: for every 10 people who have a lateral ankle sprain, one or two will have a high ankle sprain.
- This is partly because of the shape of the bones and partly because the band that goes across the inner side of the ankle joint (deltoid ligament) is much stronger than the ligaments on the other side of the ankle joint.
- A high ankle sprain (a syndesmotic sprain) is one in which the ligaments above the ankle joint are stretched or torn. These ligaments link the two bones of the lower leg (tibia and fibula).
- It is particularly common in sports such as football and hockey and also in skiing injuries. Typically the foot has been twisted forcefully away from the lower leg.
- A high ankle sprain takes twice as long to heal compared to a lateral ankle sprain.
- A high ankle sprain may be suspected if you feel that your ankle isn’t stable and you are having difficulty walking, not just because of pain.
What is the aim of treatment?
The main aims of treatment are:
- To keep inflammation, swelling and pain to a minimum.
- To be able to use the ankle joint normally again as quickly as possible.
Usually, the damaged ligament heals by itself over time. Some scar tissue may be produced where there has been a tearing of tissues.
What is the treatment for a sprained ankle?
The initial treatment is described as PRICE (Protect, Rest, Ice, Compression, and Elevation), together with avoiding HARM (Heat, Alcohol, Running, and Massage).
This treatment must be balanced fairly early with early controlled weight bearing and ensuring as normal a gait pattern as possible. This assists in retaining the power and balance of the muscles of the legs and in maintaining a healthy posture. Painkillers may be needed.
For the first 48-72 hours think of:
Paying the PRICE
- Protect from further injury:
- For example, by using a tubular bandage and/or an ankle support or a boot with high sides
- Rest the ankle joint:
- For the first two or three days following injury, consider the use of crutches when wanting to be mobile.
- It is important that the ankle is not rested for too long as this may delay recovery.
- In most cases, early controlled weight bearing with the ankle well supported is preferable to complete rest.
- Ice can be applied soon after injury:
- The cold is thought to reduce blood flow to the damaged ligament. This may limit pain, inflammation and bruising.
- Applying ice packs used to be common advice for soon after an injury but it is not known how effective it is. Some scientists think it may actually delay healing.
- If used, apply for 15-20 minutes every 2-3 hours during the day, for the first 2-3 days.
- Make an ice pack by wrapping ice cubes in a plastic bag or towel, or by using a bag of frozen peas. Do not put ice directly next to skin, as it may cause ice burn. Gently press the ice pack on to the area of your ankle that hurts.
- Do not leave ice on while asleep.
- Compression with a bandage:
- This will limit swelling and will help to rest the joint.
- A tubular compression bandage or an elastic bandage can be used.
- The bandage should not be too tight – mild pressure that is not uncomfortable and does not stop blood flow is the aim.
- A pharmacist will advise on the correct size.
- Remove the bandage before going to sleep.
- You may be advised to remove the bandage for good after 48 hours, so that the joint can move.
- This aims to limit and reduce any swelling. For example, keep the foot up on a chair to at least hip level when you are sitting. (It may be easier to lie on a sofa and to put your foot on some cushions.) When you are in bed, put your foot on a pillow.
Avoid HARM for 72 hours after injury
That is, avoid:
- Heat – for example, hot baths, saunas, heat packs. Heat encourages blood flow which will tend to increase bruising and inflammation. So, heat should be avoided when inflammation is developing. However, after about 72 hours, no further inflammation is likely to develop and heat can then be soothing.
- Alcohol, which can increase bleeding and swelling and decrease healing.
- Running, or any other exercise which may cause further damage.
- Massage, which may increase bleeding and swelling. However, after 72 hours, gentle massage may be soothing.
Your healthcare professional will advise. The advice may typically include:
- Do not stop moving the joint. Don’t do anything that causes much pain, but gently get the joint moving again. The aim is to get the ankle joint moving in normal directions, and to prevent it becoming stiff.
- Consider wearing an ankle support until symptoms have gone. There are various forms of ankle supports which can be used – from an elasticated bandage to a specialised brace. The aim is to give some support to the joint whilst the damaged ligament is healing, but to allow the ankle to move to a reasonable degree.
- Physiotherapy may help for more severe sprains, or if symptoms are not settling. A physiotherapist can advise on exercises:
- To get the ankle joint back to a full range of normal movement.
- To improve the strength of the surrounding muscles. The stronger the muscles, the less likely it is that a sprain will happen again.
- To improving proprioception. This means the ability of your brain to sense the position and movement of your joints. Good proprioception helps you to make immediate, unconscious minor adjustments to the way you walk when walking over uneven ground. This helps to prevent further sprains, and is achieved through special exercises, such as balancing on one leg and balancing on a wobble board or slider board.
- You are unlikely to be able to play sport or do vigorous exercise involving the ankle for at least 3-4 weeks after a sprain but it will depend on:
- The severity of the sprain.
- How painful it is.
- How likely you are to re-injure it.
Treatment of severe sprains
Extra treatment may be needed for some types of ankle sprain:
- Severe sprains (where the ligaments are badly torn (ruptured) or the joint is unstable).
- A high ankle sprain, where the ligament above the ankle joint is torn, making the joint unstable.
There is some evidence that these types of sprain may heal more quickly if treated with a short period of immobilisation. This means wearing a brace or a plaster cast on the lower leg and ankle for about 10 days (longer for a syndesmotic sprain).
In some cases, if ligaments are very badly torn or the joint is too unstable, surgery may be advised. Your doctor will assess if this is necessary (but it is not needed in most cases).
If the sprained ankle is still very painful six weeks after the original injury, you may be advised to have additional tests on the joint, such as a further X-ray or scan. Sometimes there are torn ligaments or small breaks (fractures) which do not show up when the injury first happens. The ankle may initially have been very swollen and small additional points of damage might have been difficult to detect.
What about medication?
You may not need any medication if the sprain is mild and you can tolerate the pain. If needed, paracetamol is the safest painkiller to use, particularly in the first few days. You can read about other painkiller options in the separate leaflet called Sprains and Strains.
When should I see a doctor?
You should see a doctor if there is any concern about the injury, or if the injury is severe. In particular, see a doctor if:
- You suspect a bone may be broken or a ligament is ruptured.
- You have a lot of tenderness over a bone.
- The leg or joint looks out of shape (deformed) rather than just swollen. This may mean there is a break (fracture) or dislocation which needs urgent treatment.
- There is loss of circulation in the foot (a numb, cold foot with pale or bluish skin). If this occurs, treatment is urgent.
- The pain is severe.
- You cannot walk or bear weight because of the injury.
- Bruising is severe.
- The joint does not seem to work properly or feels unstable after the pain and swelling have gone down. This may be a sign of an additional injury such as a torn tendon or a syndesmotic sprain.
- Symptoms and swelling do not gradually settle. Most sprains improve after a few days, although the pain often takes several weeks to go completely, especially when you use the injured joint.
What is an ankle fracture?
An ankle fracture is a break to one of the bones that make up the ankle joint. These are the tibia and fibula in the leg, the calcaneus in the heel and the talus in the front part of the ankle.
Types of fractures
Fractures may in general be:
- Open or closed: an open fracture is one where the skin is broken over the fracture so that there is a route of possible infection from the outside into the broken bones. This is obviously a more serious type of fracture, with damage to the soft tissues around the ankle, making treatment and healing more complicated, and it needs specialist assessment.
- Displaced or not displaced: a displaced fracture is one where, following the break, the bones have slipped out of line. A displaced fracture also needs specialist care, as the bones will need to be properly lined up and stabilised. This may involve an anaesthetic and some kind of metal pinning or plating to the bones.
Types of ankle fracture
There are many types of ankle fracture, depending on which bones (or combination of bones and ligaments) are damaged. Doctors classify ankle breaks (fractures) in various ways. Some classifications are based on whether the line of breakage (fracture) of the bone or bones runs through the ankle joint, just above it or just below it. Other classifications are based on particular patterns of breakage which are seen after particular types of injury. These include:
- Pott’s fracture: involving both the tibia and fibula leg bones (bimalleolar fractures). These fractures are unstable and require urgent treatment.
- Weber fracture: is a fracture of the end of the fibula (lateral malleolus). They are classified as either:
- A – the fracture is below the syndesmosis.
- B – the fracture is at the level of the syndesmosis (most common).
- C – the fracture is above the syndesmosis.
- Maisonneuve fracture: a fracture of the fibula often in combination with either a syndesmotic sprain or other fracture of the ankle.
- Pilon fracture: a fracture of the very end of the tibia and top of the talus forefoot bone. The talus is ‘driven’ into the tibia as may happen in a fall from a height or a foot braced against the floor of a car in a collision.
- Snowboarder’s fracture: this is a fracture of the outer side of the talus, produced by forced turning down and inwards of the foot at the ankle.
- Stress fracture: this is a small crack in a bone. Stress fractures often develop from overuse, such as from high-impact sports like distance running – the repeated stress of the foot striking the ground can cause problems. Stress fractures differ from other ankle fractures in that they result from overuse rather than sudden trauma. The cracks are small (although they may be multiple) so that, although they are painful, the swelling may be only slight. In the ankle, the heel (calcaneus) and the lower leg (fibula) are most commonly affected.
What does an ankle fracture look and feel like?
An ankle break (fracture) and a severe sprain may feel (and look) very similar. Both cause sudden pain, swelling and loss of weight bearing. Sprains vary in severity and may not always affect the ankle to this degree. Fractures (apart from stress fracture) are almost always severe enough to cause the following symptoms:
- Fractures cause sudden pain, and they can be very painful. People who have broken a bone stop what they are doing. They are unlikely to be able to continue running, jumping or walking.
- Swelling is a feature of broken bones, because they bleed. Bones have a rich blood supply so when broken they bleed into the surrounding tissues. This happens immediately, so the swelling from a broken ankle appears fast, with the ankle usually looking significantly swollen within the first thirty minutes.
- Bruising results as the swelling is caused by blood. It may not be immediately ‘bruise-coloured’ as it can take a while for the bruising to track through to the skin and be visible.
- Inability to weight bear: being able to take the body weight on to the injured foot is usually impossible or very painful in ankle fracture. An exception to this would be stress fracture, when impact is likely to be painful but may still be tolerable.
- Bony tenderness is seen in ankle fracture. There are particular points of tenderness which doctors look for under and around the ankle and forefoot (see diagram below). Most ankle fractures will cause tenderness in one of these areas. This is less often the case in bad sprains, so it can be a good way of determining which injuries need an X-ray.
- Deformity: if the ankle looks odd or misshapen, not just by bruising but because the foot looks twisted or out of place, a displaced fracture is likely. This is an extremely serious condition, as when bones slip out of place nerves and blood vessels may become trapped. It’s important that the fracture be assessed urgently.
When should I have an ankle X-ray?
It can be very difficult to tell a severe sprain from a break (fracture) of the ankle.
Ankle fractures need an X-ray test for diagnosis, for management and in order for you to know what to expect in terms of recovery. Sprains do not need X-ray, and doctors prefer to avoid unnecessary X-rays in order to keep your lifetime exposure to radiation as low as possible.
These are a set of rules devised by doctors to determine which ankle injuries should be X-rayed to look for fracture. They centre on whether there is bony tenderness at certain points around the ankle. If there is no bony tenderness in any of these points AND you are able to weight bear (both in casualty when seen and immediately after the injury) then fracture is unlikely and you will not need to be X-rayed. If, however, any of those features ARE present then an X-ray will be offered in order to detect or rule out fracture.
How is an ankle fracture treated?
As with all breaks (fractures), the aim is to promote healing and restore function.
- If your fracture is displaced you will need surgical management (reduction of the fracture to re-align the bones). This is likely to be done under anaesthetic, and the bones may need some form of temporary of permanent fixation to hold them in line.
- If your fracture is open then you may need surgical treatment to clean your wound and repair the soft tissue damage, in addition to having the ankle fracture assessed.
If neither of these applies (ie you have a closed, non-displaced fracture) then treatment of the fracture involves:
- Stabilisation – initially with a ‘backslab’ cast which is open on one side to allow for continuing swelling.
- Elevation – keeping the ankle raised will reduce swelling, which in turn improves healing.
- A well-moulded cast for 4-6 weeks – after this, weight bearing can be resumed.
- Some stable fractures are treated with a brace rather than a cast.
- Serial X-rays may be offered to make sure healing is taking place.
What does surgical treatment of ankle fracture involve?
Surgical treatment involving open reduction and internal fixation is considered for:
- Displaced fractures.
- Fractures which doctors think may be unstable (ie they are at risk of displacing).
- Some fractures which run through the joint and damage the ligaments which hold it together. These are called syndesmotic fractures and may need surgical repair.
What are the complications of ankle fracture?
Most ankle breaks (fractures) heal uneventfully. Possible early complications include:
- Infection (especially after open fracture).
- Damage to nerves and blood vessels (especially after displaced fracture).
- Compartment syndrome (severe swelling in the leg soon after the injury, putting pressure on nerves and blood vessels).
- Poor healing.
- Damage to skin and soft tissues by a tight or poorly finished cast.
- Burns to the skin as the plaster hardens.
- Failure of bones to knit together and heal well. This can lead to delayed union, union with poor alignment, or complete non-union even after six months.
- Temporary complications of wearing a cast include thinning of the bones and wasting of the muscles, both of which occur significantly even in a 4-6 week period of casting.
- Inflammation of the veins of the lower leg (thrombophlebitis).
- Clotting (thrombosis) of the deep veins of the leg (deep vein thrombosis) which can relate both to reduced mobility and to pressure on the leg veins from swelling and casting.
- Complications of surgical treatment of ankle fracture can include pain from, and infection around, surgical pins (which can in themselves be distressing and frightening).
Possible later complications include:
- Osteoarthritis of the ankle.
- Stiffness and loss of flexibility in the ankle.
- Long-term instability of the ankle joint, needing later correction.
- Complex regional pain syndrome (also called Sudeck’s atrophy or algodystrophy) – a nerve abnormality which can develop after fracture and which leads to continuous burning pain and gradual loss of strength. Treatment is prolonged and difficult.
- In children, damage to the growing parts of the bones of the ankle can affect overall growth
What about medication?
Painkiller options in ankle fracture are the same as for ankle sprain, above. However, rub-on (topical) treatments will not be possible if you are wearing a cast or have damage to the skin and soft tissues around the ankle.
How do I get back to full function after ankle fracture?
A period of immobilisation has lasting effects on the bones and muscles around your ankle. Therefore, both before and after the cast comes off, it is important to work towards full recovery. This may involve physiotherapy, graded exercise and sometimes use of protective ankle supports or of crutches. It is important to take the advice of your doctor or physiotherapist before using an ankle support in the long term. Whilst a support may stabilise the ankle, the best stabilisation for your ankle is the development of its own strong and supportive muscles and developing excellent proprioception.
The aim of treatment
- To build up the muscles around the joint.
- To improve proprioception and balance.
- To restore the strength of the bone through weight-bearing exercise.
- To maintain or restore the normal range of movement of the ankle joint.
Preventing sprains and fractures
Research shows that if you have had a sprained ankle while playing sport or exercising, you are twice as likely to sprain that ankle again in the following year.
Proprioception is the ability of your brain to sense the position and movement of your joints. Improving this sense has been shown to be the most effective way to prevent a repeat ankle injury in athletes. It is not clear whether proprioceptive training can also reduce the risk of a first ankle injury. A physiotherapist can advise on exercises to improve proprioception.
Examples of proprioceptive training include:
- Balancing on a wobble board or ankle disc.
- Throwing and catching a ball while standing on one leg.
- Balancing on one leg with eyes closed.
Other preventative factors
To reduce the risk of ankle injury consider:
- Exercises to build up the muscles around the ankle.
- Wearing boots that give ankle support when hiking across country or rambling over hills and uneven ground.
- Avoiding falls where possible:
- Clear paths of ice and snow.
- Avoid getting drunk.
- Take extra care if on medication that causes drowsiness.
- Keep stairways free of clutter.
- Ensure rugs and carpets can’t slip.
90,000 The difference between an ankle sprain and a fracture (disease)
Ankle sprain and fracture
Have you ever experienced an ankle sprain? Well, it was really painful for me. It happened when I was arranging things on the shelves, and the chair I was sitting on fell, and I fell. My leg landed unevenly on the concrete floor and was twisted. Pain was the first sensation I felt, followed by a warm sensation in my leg.After a while, I noticed that it was swollen.
I consulted a medical journal and learned that the best way to treat an ankle sprain is to put ice on it and lift it up to prevent further swelling. Although it hurt, I knew it wasn’t as serious as a broken ankle, because then the pain would be worse.
This is due to the fact that an ankle sprain injury occurs on the ligaments, while an ankle fracture leads to a violation of the integrity of the bone, which at times makes the pain unbearable.A mixture of acetaminophen and codeine is the best way to relieve it, while the pain of an ankle sprain can be relieved with lighter medications.
Treatment of ankle fractures aims to restore full function of the injured part, thus it is necessary to restore it to its natural position and ensure that the position is maintained until the bones heal. This will require a cast or splint on the damaged part. Surgery is sometimes necessary if all other treatments are ineffective.
The most you can get from an ankle sprain is a swollen ankle and mild pain, while a broken ankle can lead to injuries ranging from a crack in the bone to a bone that sticks out of the skin, which is very painful and requires more. time for treatment.
Although it may be difficult for you to walk with a sprained ankle, it does not immobilize you in the same way as a broken ankle. Forcing yourself to walk with a broken ankle can worsen the injury.
Recovery from a sprained ankle will take less time than from a fractured ankle, because the fracture is more severe than a sprain.
The best thing you can do if you fall or have an accident and injure your ankle is to see a doctor immediately so that you can assess the damage and obtain appropriate medication for the injury.
1. Ankle sprains ligaments are damaged, and when the ankle is fractured, the bone is damaged.
2. Sprained ankle pain can be tolerable, while the pain you feel with an ankle fracture is much worse.
3. Rest, elevation and an ice pack can ease ankle sprain, while an ankle fracture will require surgery and more drastic treatment.
4. You can still walk with a sprained ankle, walking with an ankle fracture can worsen your injury …
5. Treatment of a sprained ankle takes less time, and recovery from an ankle fracture can take several months.
90,000 Difference Between Ankle Sprain and Fracture – Difference Between
Difference Between 2021
Key Difference: An ankle sprain is when a ligament is partially torn or completely torn.Ankle fracture is when a bone in the ankle breaks.
Key Difference: Ankle sprain is when a ligament is partially torn or completely torn. Ankle fracture is when a bone in the ankle breaks.
Ankle injuries are the most common injuries suffered by people, especially in sports. The two most common types of ankle injuries are sprains and fractures.While they may appear similar due to the sheer amount of pain that follows, they differ from one another. The sprain is milder than a fracture. The ankle joint consists of three bones: the tibia, fibula, and talus. The lower leg is the main bone of the lower leg and forms the medial or inner part of the ankle joint. The fibula is a small bone that forms the lateral ankle, or the outer protrusion of the ankle. The talus is the upper bone of the foot.Damage usually occurs to these bones or the corresponding ligaments.
Ankle sprains are also known as twisted ankle, twisted ankle, ankle ligament injury, or flexible ankle. Typically, this means that the ligament is stretched to the point where it is partially torn or completely torn. It is caused by twisting the ankle either inward (more often) or outward (less often). When the ankle is bent, it causes the ligament tissue to stretch beyond its capacity to the point where it breaks or is on the verge of tearing.Ankle sprains can range from minor sprains to major sprains that may require surgery. Depending on how many ligaments have been torn or how much the tear has been torn, a sprain can either heal automatically if the damage is not so great, or require surgery to heal the ligaments. The severity of the injury also depends on previous injuries that the person may have suffered in the past. If the ligament continues to rupture, it can leave a lingering pain that will never go away.It can also cause the ligament to not heal properly, leaving the person with a limp.
When an ankle is sprained, the effects are immediate, resulting in severe pain, swelling and bruising. The area is sensitive to touch and sore when pressure is applied. In more severe dislocations, the person may hear a cracking sound or a ruptured ligament rupture. It will also hurt to walk or even stand on that leg. Swelling and bruising also occur. If it is a minor sprain, the person can relieve the pain by using painless pain relievers, keeping the leg elevated and using a cold compress to reduce the swelling.If the dislocations are more severe, a visit to the doctor is imperative to determine if the bones are broken. A doctor will diagnose a sprain based on past trauma, pain, swelling, bruising, or X-rays to confirm this. Treatment includes the popular anagram known as PRINCE, which translates to: Protection, Rest, Ice, NSAIDs or other pain relievers, Squeeze and boost.
Common symptoms of ankle sprains include:
- Pressure at the point of impact
Ankle fracture is a fracture of the bones of the ankle.The three bones, the tibia, fibula, and talus, are bones that usually break as a result of twisting, twisting, or impact. If the stress on the ankle is too much, it will break the bone, resulting in a fracture. In the case of twisting and twisting, fractures occur simultaneously with torn ligaments. The pressure would first rupture the ligaments before the bone broke. The fracture is most often identified using x-rays. The doctor may not diagnose the problem until he sees bone fractures on an x-ray.A fracture is considered a more dangerous problem than a sprain, which can heal easily. A fracture takes time to heal and requires proper bone healing and must be properly aligned to keep the person from constant pain or lameness problems. Depending on the severity of the fractures and tears in the ligament tissue, the person may also need surgery to straighten the bones.
During a fracture, a person may hear a bone click or feel a bone fracture.This is usually followed by excruciating pain when the person is unable to walk or even stand on that particular leg. Swelling, bruising, and the formation of fluid (pus) are also common with fractures. In addition, depending on the pressure exerted on the bone, causing it to collapse, it can also cause the bone to tear off the skin and flake off, leading to blood formation. Minor fractures require only a plaster cast or splint and pain relievers, while more serious fractures require surgery, plaster correction, and physical therapy to get the muscles and bones back into motion.
Fracture symptoms include:
- Severe pain
- Inability to walk or stand
- Bone dislocation
- Bones visible on the outside of the skin
- Pain in the entire area, not just the ankle
- Blue leather
Fracture of the ankles
Causes and Symptoms
A typical mechanism for ankle fracture is a twist of the foot, which can occur when stumbling and falling.Also, a fracture can occur as a result of direct injury (such as an accident) or a fall from a height. Depending on the severity and location of the fracture, treatment may include a plaster cast, orthotics, or surgery.
The fracture is characterized by severe pain when the limb is loaded or moved with the foot, progressive swelling and bruising around the ankle. Possibly unusual position of the foot. With an open fracture, when the skin is simultaneously damaged, there is a wound.
First aid for ankle fracture – ankle immobilization.It is carried out at the site of injury with improvised means or medical splints.
Immobilization serves two purposes. First, it is the prevention of soft tissue damage by bone fragments. Secondly, immobilization reduces pain.
Conservative treatment is possible for fractures without displacement. Also, fractures are usually not subject to surgical treatment in patients with severe concomitant diseases when there is a high risk of complications. Usually, a contraindication to surgical treatment is severe circulatory disorders of the lower extremities, incl.hours with the formation of trophic ulcers, and infections of the soft tissues of the forefoot.
When swelling increases, the plaster cast is dissected to prevent damage to the skin. When the swelling decreases, the calcined plaster cast is replaced with a new circular bandage. Based on the results of an X-ray examination, the doctor removes the plaster cast and gradually allows the injured limb to be loaded. In some cases, the load on the leg is allowed even before the plaster cast is removed.
If the fracture is accompanied by a strong displacement of the fragments, surgical treatment is necessary to restore the anatomy of the joint. Surgery is also necessary if the tibiofibular syndesmosis (the ligament between the tibia and fibula) is damaged. For open fractures, surgery is best performed within a few hours of the injury. With severe edema, the operation is postponed until the edema subsides.Before surgery, a dissected plaster cast is applied to the leg. To speed up the absorption of the edema, it is recommended to keep the leg in an elevated position.
While the limb is in a plaster cast, special exercises should be performed to prevent muscle atrophy and thrombosis. Thrombosis prophylaxis should be carried out until the full load on the leg is allowed. In addition to exercise, heparin injections are used for complex prophylaxis, especially during the period when the patient is prescribed bed rest.
Ligament damage often occurs during sports.
Tendons and ligaments
90,000 Fractures of the ankle joint in children in Dnipro
Broken ankle, also called ankle fracture (synonymous with ankle fracture, ankle fracture, etc.) is a common injury. An ankle fracture is a fracture of one or more bones that make up the ankle: the lower leg, fibula, and talus.
Types of fractures:
- Single ski
Ankle injuries usually occur during sports or vigorous play when the lower leg or leg is suddenly twisted.
Sports that involve lateral movement and jumping – like basketball – may put you at greater risk of ankle injuries.Twisting force on the lower leg or foot is a common cause of ankle fractures and ligament injuries (sprains).
Without radiography, it is often difficult to distinguish between an ankle sprain and a more serious ankle fracture. Initially, sprains and fractures can cause pain and swelling.
However, a strong sign of a fracture is when a person is unable to gain weight on an injured ankle.
After discussing your child’s medical history and how the injury occurred, your doctor will do a thorough examination.Your doctor will analyze:
- Deformed or bent ankle appearance
Magnetic resonance imaging (MRI). If a physical exam suggests a fracture but the x-ray does not show it, your doctor may order a magnetic resonance imaging (MRI) scan. These tests produce high-resolution images of both bones and soft tissues such as ligaments.
Computed tomography (CT). This type of scan can create a cross section of the ankle. This is especially helpful when the fracture extends to the ankle joint.
There are two types of treatment: operational and non-operational!
The easiest way to understand and easily determine where to operate and where to treat with “plaster”.
If there are X-ray images where there is displacement (of the bones), it is necessary to be operated on unambiguously!
What will happen if you do not have surgery? The pain and swelling will remain forever and everything will end with the closure of the joint!
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Rehabilitation after a broken leg | “Laboratory of Movement” SPb
Despite the fact that many injuries do not require surgical correction, a sufficiently long treatment process can lead to negative health consequences.To speed up the recovery time from a broken leg, specialists at the Movement Laboratory health center in St. Petersburg are using an innovative approach to rehabilitation. In addition to the above-mentioned conservative methods, innovative technologies are used here to improve the final result:
CPM (Continues Passive Motion) means “constant passive motion”. Rehabilitation simulators are used for fractures of the ankle, calcaneus and talus.They help to mobilize joints and correct anatomical movement, and prevent the formation of contractures.
Proprioceptive neuromuscular fatigue (PNF) is a type of motion therapy aimed at restoring functional connections between muscles and the central nervous system. Manual stimulation (stretching and squeezing of prioreceptors) eliminates muscle spasms and pain syndrome, improves the condition of the motor centers, restores lost movement patterns.
Instrumental mobilization of soft tissues IASTM
IASTM-therapy – kinesio correction using special instruments (blades). Stimulation of soft tissue injuries accompanying a bone fracture reduces pain syndrome, activates the growth of fibroblasts, prevents the development of cicatricial changes and facilitates the healing process.
NEURAC Kinesiotherapy is actively used to restore leg mobility after plaster cast removal. The technique, aimed at working out weakened deep muscles and neuromuscular activation, includes sets of exercises on a specialized harness.Classes are held in the absence of axial load on the spine and joints. Controlled range of motion and vibration helps to eliminate pain and normalize the work of the musculoskeletal system.
Manual therapy (Mulligan and Kaltenborn – Event concept)
Mobilization with movement is an effective rehabilitation method recommended for leg fractures after plaster cast removal. The simultaneous active physiological movements of the patient and the auxiliary support of the chiropractor in the “correct” treatment plane contribute to the acceleration of the painless work of the joints.
To adapt the body after trauma and improve overall health, the “Laboratory of Movement” RC uses the practices of yoga therapy and Pilates. With their help, post-traumatic stress is reduced, an increase in bone density along the fracture line is accelerated, and the consequences of prolonged forced hypokinesia are eliminated.
90,000 Fracture of the ankle with and without displacement, how long to walk in a cast
© Dotan – stock.adobe.com
Supporting functions and mobility of the ankle are provided by the distal epiphyses (ends) of the fibula and tibia.This joint accounts for shock loads when walking, running, jumping, as well as jerky lateral and twisting moments of force when balancing to keep the body in an upright position. Therefore, ankle fracture is one of the most common injuries of the musculoskeletal system, not only among athletes, but also among ordinary people who do not go in for sports (from 15 to 20% of the total).
Traumatic ankle fractures occur from a strong blow or other excessive external impact on the ankle during sports, falls, road accidents.Rolling your foot on a slippery, uneven surface or wearing uncomfortable shoes will often cause this injury. Underdeveloped muscles and poor coordination of movements, especially with excess weight, can provoke unsuccessful falls. Due to disturbances in the normal process of bone tissue repair, adolescents, pregnant women and the elderly are at risk.
Congenital or acquired degenerative changes, as well as various diseases, such as arthritis, osteopathy, osteoporosis, tuberculosis, and oncology, increase the likelihood of injury.Unbalanced nutrition, lack of calcium and other trace elements reduce bone strength and elasticity of ligaments.
What is the danger
With timely and qualified treatment, even complex fractures, as a rule, heal without complications and the ankle’s working capacity is fully restored. In cases of severe displacement or fragmentation of bones, serious complications are possible and only partial rehabilitation of the functionality of the joint.
In the event of a late appeal to a medical institution or improper first aid provision, serious consequences can occur, up to the onset of disability.
Open fractures and displaced fractures are especially dangerous, when bone fragments can damage the surrounding tissues and nerve endings, which threatens with loss of sensitivity and disruption of the foot muscles. Therefore, it is important at the first moment to ensure the immobilization of the limb, not to allow any load on the injured leg, and as quickly as possible to deliver the patient to the emergency room.
Sometimes a closed fracture worries only about the swelling of the joint, minor pain, and the ability to walk remains.Despite this, and in such cases, it is necessary to consult a doctor to establish an accurate diagnosis and correct treatment.
Fracture of the outer malleolus
This is the destruction of the lower end of the fibula. The ICD-10 (International Classification of Diseases) code is S82.6. For such an injury, mild symptoms are characteristic – swelling of the ankle joint, sharp pain at the time of injury and tolerable pain even when leaning on the leg, since the main load falls on the tibia.This often provokes a delay in contacting a traumatologist, which can cause improper bone fusion and destruction of ligaments, muscles and nerve fibers. As a result, an easily treatable fracture of the external ankle can turn into a serious pathology.
Fracture of the inner ankle
This is the destruction of the lower end of the fibula (according to ICD-10 – S82.5.). In such cases, oblique or straight (pronation) fractures of the medial malleolus occur, which are often complicated by sprains, and can be accompanied by acute pain, loss of support function of the leg, severe swelling and bruising in the joint area.
Fracture with offset
These are the most dangerous and difficult cases of ankle injury, which have pronounced symptoms: sharp intolerable pain, severe swelling, extensive local hemorrhage and a characteristic crunch when the muscles of the leg are strained or the foot is moved. Sometimes a piece of bone destroys the surrounding tissue and comes out, provoking bleeding and the danger of infection in the wound. This often occurs with an apical fracture (fracture of the tibia or fibula near the distal pineal gland).In the most severe cases, both ankles are injured with dislocation and rupture of the ligaments.
Fracture without offset
These injuries are characterized by the destruction of the distal part of the lower leg without acute pain and severe edema. There is only slight discomfort when bending the foot and walking.
A non-displaced ankle fracture can be confused with a sprain, so it is best to check the diagnosis with a healthcare professional.
The exact location and degree of damage are established by means of an X-ray examination.Several shots are always taken in different planes (from two or more, depending on the complexity of the injury). To assess the condition of soft tissues and ligaments, as well as to exclude the presence of internal hematomas, magnetic resonance imaging or computed tomography is prescribed.
© richard_pinder – stock.adobe.com
Features of treatment
The main way to restore the integrity of the bone is the complete immobilization of the ankle joint. Depending on the type of injury, the correct position of the fragments is ensured by closed or open reduction.After surgery, the necessary procedures are carried out to heal the wound.
Such methods are used in cases of closed fractures without displacement or if it can be eliminated by closed reduction, and the ligamentous apparatus has minor damage. In addition to immobilization, medications are used to relieve pain, edema and eliminate inflammatory processes.
The unsatisfactory state of the patient’s health may be the reason for refusing surgery and the use of conservative treatment.
Using an immobilizing dressing
In case of an uncomplicated fracture without displacement and rupture of the ligaments, after establishing the diagnosis and eliminating the edema, an immobilizing U-shaped or longitudinal circular bandage of plaster, synthetic bandage or low-temperature plastic is applied. Covering a part of the foot and the lower part of the lower leg, it should provide a clear fixation of the joint and not interfere with normal blood circulation in the limb. In the case of such immobilization, after closed reduction, a control X-ray is imperative to make sure that the fragments are in the correct position.
In addition to bandages, various versions of plastic and combined bandages and orthoses are used. Such devices are easily adjusted to the size of the limb. With the permission of your doctor, you can take them off and put them on yourself.
Depending on the complexity of the fracture, any load on the immobilized limb is excluded for a certain period of time. The timing of wearing a fixation device or bandage also depends on this (from 4-6 weeks to two months or more).
© stephm2506 – stock.adobe.com
Closed manual reduction
This procedure is performed under local anesthesia. The surgeon feels the docking and alignment of the displaced bones and ensures their correct anatomical position in the joint and lower leg.
Time and quality of limb health restoration largely depends on the timeliness and accuracy of its implementation.
Performing a surgical operation is required:
- With an open fracture.
- When the injury is complicated by a complete rupture of the ligaments or there are many fragments.
- For two- or three-malleolar fractures.
In these cases, under general anesthesia, the joint is opened and bones and fragments are openly repositioned, as well as their fixation with special medical nails, screws and pins (osteosynthesis). At the same time, damaged tendons, ligaments and nerve endings are restored. Then a plaster cast is applied, which does not cover the surgical site and allows the treatment and control of the wound healing process.
In case of a late visit to a doctor, self-treatment or violation of the rules and terms of wearing the fixation device, bones and their fragments can grow together in an unnatural position, which will interfere with the normal functioning of the joint and provoke dislocations and the development of flat feet.
An improperly formed callus can pinch nerve fibers and obstruct or block the innervation of the adductor muscles of the foot and the sensitivity of the skin.Untimely treatment of a postoperative wound can cause the development of an inflammatory process or an infectious disease of muscle tissues, bones and blood vessels.
How long to walk in a cast in case of ankle fracture
In any case, the plaster cast or other fixation device is removed only after a control X-ray, which confirms the complete and correct fusion of bones and fragments, as well as the normal condition of the ligaments and tendons.
First of all, the timing of wearing the fixing device depends on:
- Timeliness and correctness of first aid.
- The type and complexity of the fracture.
- Individual characteristics of the patient’s body.
Acceleration of recovery is facilitated by a balanced diet and adherence to the recommendations of the attending physician.
In this case, the decisive factor is the correct preliminary fixation of the joint during the first aid and the quick delivery of the victim to the emergency room.Otherwise, the displacement can become difficult to correct with closed reduction and surgical intervention is required.
In most cases of such fractures, immobilization lasts from one to two months. The time of complete recovery depends on the intensity of the rehabilitation measures and the individual characteristics of the patient.
In case of damage to the outer part
Such fractures are treated with surgery, so it will take two months or more to wear a fixation bandage.As after any surgical operation, in this case, the recovery period is also determined by the rate of healing of the postoperative wound.
With a fracture of the lateral malleolus without displacement
This is the easiest case of ankle fracture, and joint fixation is required for a period of one to one and a half months. Already after a week, a gradual normalized load on the leg is allowed.
Stages of accretion
At the time of the fracture, local hemorrhage occurs, and the first five, seven days there is an inflammatory process with the formation of a soft compaction from fibrous tissue (resorption).Then the creation of collagen connecting threads (reversion) from special cells – osteoclasts and osteoblasts – begins. After that, as a result of cell mineralization, a callus is formed between the fragments within a month. In the next three to four weeks, the ossification of the formed structure occurs, due to its saturation with calcium.
Complete restoration of the damaged bone and its surroundings, which ensures the full functioning of the ankle joint, possibly after 4-6 months of rehabilitation.
Duration of rehabilitation
The rehabilitation period can last from four to six months or more. It depends on the complexity of the fracture, the methods of treatment used and the characteristics of the individual person – age, health, lifestyle and the presence of bad habits. The acceleration of recovery processes is facilitated by:
- Early start of a dosed load on the injured leg and performing therapeutic exercises.
- Local massages and various physiotherapy treatments.
- Balanced nutrition, which provides the body with the necessary substances and minerals (primarily calcium).
- An active life position – performing all prescribed procedures, regular exercise therapy (exercise therapy) and the development of joint mobility, despite the permissible pain and weakness of atrophied muscles.
The first exercise therapy exercises for ankle fracture should be started immediately after the pain syndrome has been relieved on the recommendation or under the supervision of a medical specialist.