Healing fractured foot: Metatarsal fracture (acute) – aftercare: MedlinePlus Medical Encyclopedia
Bone Healing – Foot Health Facts
How Does a Bone Heal?
All broken bones go through the same healing process. This is true whether a bone has been cut as part of a surgical procedure or fractured through an injury.
The bone healing process has three overlapping stages: inflammation, bone production and bone remodeling.
- Inflammation starts immediately after the bone is fractured and lasts for several days. When the bone is fractured, there is bleeding into the area, leading to inflammation and clotting of blood at the fracture site. This provides the initial structural stability and framework for producing new bone.
- Bone production begins when the clotted blood formed by inflammation is replaced with fibrous tissue and cartilage (known as soft callus). As healing progresses, the soft callus is replaced with hard bone (known as hard callus), which is visible on x-rays several weeks after the fracture.
- Bone remodeling, the final phase of bone healing, goes on for several months. In remodeling, bone continues to form and becomes compact, returning to its original shape. In addition, blood circulation in the area improves. Once adequate bone healing has occurred, weightbearing (such as standing or walking) encourages bone remodeling.
How Long Does Bone Healing Take?
Bone generally takes six to 12 weeks to heal to a significant degree. In general, children’s bones heal faster than those of adults. The foot and ankle surgeon will determine when the patient is ready to bear weight on the area. This will depend on the location and severity of the fracture, the type of surgical procedure performed and other considerations.
What Helps Promote Bone Healing?
If a bone will be cut during a planned surgical procedure, some steps can be taken pre- and postoperatively to help optimize healing. The surgeon may offer advice on diet and nutritional supplements that are essential to bone growth. Smoking cessation and adequate control of blood sugar levels in people living with diabetes are important. Smoking and high glucose levels interfere with bone healing.
For all patients with fractured bones, immobilization is a critical part of treatment because any movement of bone fragments slows down the initial healing process. Depending on the type of fracture or surgical procedure, the surgeon may use some form of fixation (such as screws, plates or wires) on the fractured bone and/or a cast to keep the bone from moving. During the immobilization period, weightbearing is restricted as instructed by the surgeon.
Once the bone is adequately healed, physical therapy often plays a key role in rehabilitation. An exercise program designed for the patient can help in regaining strength and balance and can assist in returning to normal activities.
What Can Hinder Bone Healing?
A wide variety of factors can slow down the healing process. These include:
- Movement of the bone fragments; weightbearing too soon
- Smoking, which constricts the blood vessels and decreases circulation
- Medical conditions, such as diabetes, hormone-related problems or vascular disease
- Some medications, such as corticosteroids and other immunosuppressants
- Fractures that are severe, complicated or become infected
- Advanced age
- Poor nutrition or impaired metabolism
- Low levels of calcium and vitamin D
How Can Slow Healing Be Treated?
If the bone is not healing as well as expected or fails to heal, the foot and ankle surgeon can choose from a variety of treatment options to enhance bone growth, such as continued immobilization for a longer period, bone stimulation or surgery with bone grafting or use of bone growth proteins.
Broken foot – Diagnosis and treatment
During the physical exam, your doctor will check for points of tenderness in your foot. The precise location of your pain can help determine its cause.
They may move your foot into different positions, to check your range of motion. You may be asked to walk for a short distance so that your doctor can examine your gait.
If your signs and symptoms suggest a break or fracture, your doctor may suggest one or more of the following imaging tests.
- X-rays. Most foot fractures can be visualized on X-rays. The technician may need to take X-rays from several different angles so that the bone images won’t overlap too much. Stress fractures often don’t show up on X-rays until the break actually starts healing.
- Bone scan. For a bone scan, a technician will inject a small amount of radioactive material into a vein. The radioactive material is attracted to your bones, especially the parts of your bones that have been damaged. Damaged areas, including stress fractures, show up as bright spots on the resulting image.
- Computerized tomography (CT). CT scans take X-rays from many different angles and combine them to make cross-sectional images of internal structures of your body. CT scans can reveal more detail about the bone and the soft tissues that surround it, which may help your doctor determine the best treatment.
- Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to create very detailed images of the ligaments that help hold your foot and ankle together. This imaging helps to show ligaments and bones and can identify fractures not seen on X-rays.
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Treatments for a broken foot will vary, depending on which bone has been broken and the severity of the injury.
Your doctor may recommend an over-the-counter pain reliever, such as acetaminophen (Tylenol, others).
After your bone has healed, you’ll probably need to loosen up stiff muscles and ligaments in your feet. A physical therapist can teach you exercises to improve your flexibility and strength.
Surgical and other procedures
- Reduction. If you have a displaced fracture, meaning the two ends of the fracture are not aligned, your doctor may need to manipulate the pieces back into their proper positions — a process called reduction. Depending on the amount of pain and swelling you have, you may need a muscle relaxant, a sedative or even a general anesthetic before this procedure.
Immobilization. To heal, a broken bone must be immobilized so that its ends can knit back together. In most cases, this requires a cast.
Minor foot fractures may only need a removable brace, boot or shoe with a stiff sole. A fractured toe is usually taped to a neighboring toe, with a piece of gauze between them.
- Surgery. In some cases, an orthopedic surgeon may need to use pins, plates or screws to maintain proper position of your bones during healing. These materials may be removed after the fracture has healed if they are prominent or painful.
Preparing for your appointment
You will likely initially seek treatment for a broken foot in an emergency room or urgent care clinic. If the pieces of broken bone aren’t lined up properly for healing, you may be referred to a doctor specializing in orthopedic surgery.
What you can do
You may want to write a list that includes:
- Detailed descriptions of your symptoms
- Information about medical problems you’ve had
- Information about the medical problems of your parents or siblings
- All the medications and dietary supplements you take
- Questions you want to ask the doctor
For a broken ankle or foot, basic questions to ask your doctor include:
- What tests are needed?
- What treatments are available, and which do you recommend?
- If I need a cast, how long will I need to wear it?
- Will I need surgery?
- What activity restrictions will need to be followed?
- Should I see a specialist?
- What pain medications do you recommend?
Don’t hesitate to ask any other questions you have.
What to expect from your doctor
Your doctor may ask some of the following questions:
- Was there a specific injury that triggered your symptoms?
- Did your symptoms come on suddenly?
- Have you injured your feet in the past?
- Have you recently begun or intensified an exercise program?
What to do in the meantime
If your injury isn’t severe enough to warrant a trip to the emergency room, here are some things you can do at home to care for your injury until you can see your doctor:
- Apply ice for 15 to 20 minutes at a time, every three to four hours to bring down the swelling.
- Keep your foot elevated.
- Don’t put any weight on your injured foot.
- Lightly wrap the injury in a soft bandage that provides slight compression.
May 23, 2020
- Brunicardi FC, et al., eds. Orthopedic surgery. In: Schwartz’s Principles of Surgery. 10th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://www.accessmedicine.com. Accessed Dec. 10, 2016.
- Sprains, strains and fractures. American Podiatric Medical Association. http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=982. Accessed Dec. 17, 2016.
- Ankle fractures (broken ankle). American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00391. Accessed Dec. 10, 2016.
- Stress fractures of the foot and ankle. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00379. Accessed Dec. 10, 2016.
- Toe and forefoot fractures. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00165. Accessed Dec. 11, 2016.
- Tintinalli JE, et al. Foot injuries. In: Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 8th ed. New York, N.Y.: The McGraw Hill Companies; 2016. http://www.accessmedicine.com. Accessed Dec. 10, 2016.
- Stress fracture. American Orthopedic Foot and Ankle Society. http://www.aofas.org/footcaremd/conditions/ailments-of-the-midfoot/pages/stress-fractures.aspx?PF=1. Accessed Dec. 17, 2016.
- Once is enough: A guide to preventing future fractures. NIH Osteoporosis and Bone Diseases National Resource Center. http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Fracture/. Accessed Dec. 10, 2016.
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Broken Foot Overview
Broken bones (also called fractures) in the foot are very common. In fact, about 1 out of every 10 broken bones occurs in the foot. Here’s why.
- The human foot has 26 bones.
- Divide the foot into 3 parts: the hindfoot, the midfoot, and the forefoot.
- There are 2 bones in the hindfoot. These are the talus, which is where the foot attaches to the leg, and the calcaneus, which forms the heel.
- Five smaller bones called the navicular, cuboid, and 3 cuneiforms make up the midfoot.
- The long part of the foot is called the forefoot and contains 19 bones. There is a metatarsal for each of the 5 toes, the big toe is made up of 2 phalanges, and the other toes each have 3 phalanges.
- In addition, the foot sometimes has some small pebble-like bones called sesamoid bones. These bones do not perform any necessary function and are often called accessory bones.
Broken Foot Causes
Bones usually break when something happens to crush, bend, twist, or stretch the bone.
- Toes are often broken when you accidentally kick something hard.
- Heels are often broken when you fall from a height and land on your feet.
- Other bones in the foot sometimes break when you twist or sprain an ankle.
- Most bones break suddenly because of an accident. Occasionally, small cracks can form in bones over a longer period of time from repeated stress on the bones. These are called stress fractures. They occur most commonly in soldiers hiking in full gear or in athletes, such as dancers, runners, and gymnasts.
- Broken bones are more common in children than in adults.
- In adults, bones are stronger than ligaments (which connect bones to other bones) and tendons (which connect bones to muscles). But in children, ligaments and tendons are relatively stronger than bone or cartilage. As a result, injuries that may only cause a sprain in an adult may cause a broken bone in a child. However, a child’s forefoot is generally flexible and very resilient to injuries of any kind.
- When metatarsal or phalangeal fractures do occur, they may be difficult to recognize, because many parts of a growing child’s bone do not show up well on X-rays. For this reason, it is sometimes helpful to get X-rays of the child’s other, uninjured foot to compare to the hurt foot.
Broken Foot Symptoms
Broken bones in the foot cause pain and swelling.
- Usually (but not always) the pain is so bad, that you are not able to walk. Broken bones in the toes cause less pain, and you may be able to walk with a broken toe.
- Bruising of the foot with a broken bone is also common.
- Sprains can also cause bad pain, swelling, and bruising, so it is usually not possible to tell if a foot is broken or sprained just by looking at it.
Here’s what to do when examining an injured foot for a possible broken bone.
- Take the shoes and socks off both feet and compare them side by side to figure out how much swelling is present in the injured foot.
- Look for any large cuts or wounds. Large cuts or wounds that expose a broken bone are more serious.
When to Seek Medical Care
It is important to see a doctor any time you think you may have broken a bone in your foot.
For less severe injuries, your doctor may want to see you in the office or may choose to have you go to the emergency department. If you think you have broken your foot, and you can’t reach your doctor right away, it is reasonable to go to the emergency department to be examined.
Call 911, if needed, for transport to the emergency department. Do not attempt to drive with a broken foot.
Go immediately to the nearest emergency department if these conditions develop with a suspected broken foot:
- The foot is blue, cold, or numb.
- The foot is misshapen, deformed, or pointing in the wrong direction.
- There is a large cut or wound near a possible broken bone.
- You have severe pain.
- You feel you need immediate treatment for any other reason.
Exams and Tests
The doctor will ask you about the injury and examine you. X-rays are often useful in diagnosing broken bones in the foot, but sometimes they are not needed.
- Injured toes are usually treated in the same way whether they are broken or just bruised, so X-rays are often optional for these injuries.
- Sometimes a doctor’s examination is all that is needed to be certain bones in the midfoot are not broken. Doctors may use the “Ottawa foot rules” to decide if an X-ray is needed. An X-ray is required only if there is any pain in the malleolar “mid foot” zone AND any one of the following symptoms is present:
- Pain when the doctor pushes over the base of the fifth metatarsal bone
- Pain when the doctor pushes over the navicular bone
- Inability to take 4 steps, both immediately after injury and at the examination
- Other ways of taking pictures of the bones of the foot (such as a bone scan, CT, MRI, or ultrasound) can be performed to look for unusual or hidden injuries, but they are rarely needed. These tests generally are not obtained while in the emergency department and usually are ordered only after consultation with an orthopedist or foot surgeon.
Broken Foot Treatment Self-Care at Home
First aid for people with foot injuries is stabilization and elevation of the injured foot.
- Any splint that keeps the injured foot from moving is effective. Often a pillow wrapped around the foot like a stirrup and then taped or tied with an elastic bandage works well.
- Do not wrap the foot so tightly that it cuts off the blood supply to the foot. Any splint that causes the foot to hurt worse, turn blue, or makes it more difficult to wiggle the toes, should be removed right away.
- Elevation of the injured foot reduces swelling and pain. Proper elevation requires the foot to be at a level higher than the rest of the body. Lie flat with the foot propped up on several pillows.
- Ice wrapped in a small towel and applied to the injured foot may also reduce swelling and pain for the first several hours after an injury.
- Do not attempt to walk on an injured foot if walking is painful.
Injured toes usually heal well even if they are broken. They can usually be treated at home unless the toe seems to be very deformed or pointing in the wrong direction.
- Treatment involves splinting the injured toe to the good toe next to it. This is called “buddy taping.”
- Place some padding (usually cotton balls) between the injured and good toe and tape them securely with a wide medical tape. They should be secure enough to provide support but not so tight as to cut off blood supply to the toes.
- A shoe with a fairly rigid sole like a wooden sandal, a clog, or a rigid flat-bottom shoe from a medical supply store is also helpful.
Treatment for a broken bone in the foot depends on which bone is broken and how it is broken. Some broken bones in the foot can be treated with crutches and flat-bottom shoes, others require splints or casts, and still others require surgery to repair the bones.
- Crutches are used to help you walk when you have a hurt foot.
- When walking using crutches it is important that they fit right and that you use them correctly. Your doctor should adjust your crutches to fit you and show you how to use them.
- When using crutches, it is important to put your weight on your arms and hands. Do not put your weight on your underarms (armpits). This could hurt the nerves that are in your underarms.
- To avoid falling, use your crutches only on firm ground.
Your doctor will tell you whether or not you should bear any weight on your injured foot.
- To use crutches in a “non-weight bearing” way, you should keep the knee of your injured leg bent whenever you walk, to keep the injured foot from ever touching the ground. Do not let it touch even to help with balance.
- To use crutches for “partial weight bearing” or “weight bearing as tolerated,” you can let your injured foot touch the ground only when the crutches are also touching the ground, so that some of your weight is on your foot and some is on the crutches. Always let your injured leg swing with the crutches. If it hurts when you walk, put more weight on the crutches and less on your injured foot.
Follow-up with your doctor or orthopedist often is needed to make sure that foot fractures are healing well. Follow-up is particularly important if pain continues or if you have difficulty walking.
It is always better to prevent broken bones than to treat them.
- Construction workers and others at risk for foot injuries should always wear steel-toed protective boots.
- Sports always should be performed with well-fitting supportive athletic shoes.
- When riding in a car, do not allow passengers to dangle feet out the window or place feet up on the dashboard.
- Always wear a seatbelt when riding in a car.
Toe fractures are common and generally heal well with little or no therapy. Although the bones may take 3-8 weeks to heal, pain usually improves much earlier. Rarely, very severe fractures, especially of the big toe, may require a cast or surgery.
- Metatarsal fractures usually heal well. The first metatarsal (the one attached to the big toe) sometimes requires a cast or surgery and a prolonged period on crutches, but the middle 3 metatarsals can usually be treated with a rigid flat-bottom shoe and partial weight bearing. “March fracture” is a metatarsal stress fracture that commonly occurs in joggers and requires stopping jogging for 4-6 weeks.
- The fifth metatarsal (the one attached to the pinkie toe) is the most commonly broken bone in the midfoot. There are 2 general types.
- One type is the proximal avulsion fracture. These are very common and usually happen at the same time as a sprained ankle. They heal very well with a rigid flat-bottom shoe or elastic bandage and weight bearing as tolerated.
- The other type is the Jones fracture, which is much less common but does not heal as well. This fracture gets worse with time if you keep walking on it, so non-weight bearing is very important. People with this fracture are more likely to develop problems healing that require an operation.
- Fractures at the joint between the cuneiforms and the metatarsals are called Lisfranc fractures. These are rare, but can be difficult to diagnose and treat. Weight-bearing X-rays (taken while standing on the injured foot) are sometimes needed to look for this problem. These fractures sometimes require surgery.
- Navicular fractures are rare and most often represent stress fractures in young athletes. They usually heal well with a rigid flat-bottom shoe and weight bearing as tolerated. Severe fractures through navicular bone sometimes require surgery.
- Calcaneal fractures often occur in people who fall from a height and land on their feet. These people often have other injuries as well, so they should be examined carefully. The most common fracture of the calcaneus, the intraarticular joint depression fracture, usually requires surgery. Other fractures of the calcaneus can usually be treated with splints or casts and non-weight bearing.
- There are many types of Talar fractures, some of which are difficult to diagnose and treat. Lateral process fractures often occur from snowboarding injuries. Posterior process (Shepherd) fractures are found in athletes who dance or kick. The diagnosis of these injuries often cannot be made in the doctor’s office or emergency department on the initial visit and require bone scans or other studies if symptoms continue. Treatments vary but often require splints or casts and a period of non-weight bearing.
Media file 1: Broken foot. Proper use of crutches is shown on the left. Crutch tips are shoulder width apart. Elbows are straight and locked. Pads at the top of the crutches are 3 fingerbreadths below the armpit and press against the side of the chest. Incorrect use of crutches is shown on the right.
Media file 2: Broken foot. Proper use of crutches for non-weight bearing. The knee on the injured leg is bent to keep the injured foot off the ground. Crutch tips are placed in front of you as you walk, and the good leg swings forward between the crutches as shown.
Synonyms and Keywords
foot fractures, sesamoid bones, toe fracture, metatarsal fracture, Lisfranc fracture, navicular fracture, calcaneal fracture, talar fracture, broken foot, Ottawa foot rules
7 Tips for Recovering from a Broken or Dislocated Foot
Last Updated: August 31, 2020
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Get back on your feet with some simple techniques.
Your foot is complex. It contains nearly one-fourth of all the bones in your body. So foot fractures and dislocations can be either simple—involving just one bone—or complex—involving multiple bones. Recovery from a foot fracture or dislocation depends on the type, location, complexity and treatment. Some simply need rest, while others require weeks of rehabilitation.
1. Start with specific recovery goals to focus your energy.
Your goal during recovery is to manage your symptoms and regain pain-free, pre-injury foot function. This can take a long time and be quite a challenge depending on the type of foot fracture and the extent of the injury. In some cases, foot function and the way you walk may never return to pre-injury levels. Talk to your doctor from the very beginning about the best strategies for these goals and what you can expect.
2. Manage your symptoms with PRICE.
Common symptoms of a simple broken foot include pain, tenderness, bruising and swelling. You can manage these symptoms by following PRICE—protection, rest, ice, compression and elevation. You may need to do this for at least 48 hours. Ask your doctor about taking over-the-counter pain relievers, such as ibuprofen (Advil, Motrin) or naproxen (Aleve). More complex injuries may require more aggressive measures.
3. Keep weight off your foot.
Your doctor may tell you not to put weight on your foot. This can last for several weeks as the bone heals. Crutches will help you get around while keeping weight off the foot. Or you may only need a rigid boot to provide stability if your doctor allows weight bearing. Once the crutches or boot are gone, it’s important not to overload your bone. Depending on your age and the injury, it can take several months or years to regain full bone strength.
4. Start slow and go slow.
Your doctor may encourage you to move your foot soon after the injury. If you’ve had surgery, your doctor may recommend movement as soon as the wound heals. Gradually, you’ll add activities and intensity. Follow your doctor’s instructions for activities and movement. Doing too much too fast can cause problems, such as having the bone move out of position. If your foot starts to hurt, it’s time to rest it. Ask your doctor when it is safe to return to daily activities, work, and sports or other leisure activities.
5. Stick with your exercises and physical therapy.
You will start therapeutic exercises once your fracture is stable. This includes range-of-motion, stretching, and strengthening exercises. For simple fractures, your doctor may recommend exercises you can do at home to regain function. In other cases, you may work with a physical therapist. These exercises can be painful at first. Talk to your doctor or therapist about managing the pain so you can reach your recovery goals.
6. Look out for possible complications.
Call your doctor right away if you have fever, color changes in the foot or leg, numbness, tingling, more swelling than expected, or increased pain. These could be signs of a complication. Arthritis and chronic pain can occur long after a foot fracture. Talk to your doctor if your symptoms are not going away or return after your foot heals.
7. Take steps to prevent future injuries.
If your injury was from a stress fracture, your doctor or therapist may recommend changes to your exercise routine to help prevent future problems. This includes cross-training and alternating days of high- and low-intensity activities. For any type of fracture, it will help to build muscle strength around the bone and to start new activities slowly. You should also aim to eat a balanced diet that includes calcium and vitamin D for bone strength. Ask your doctor whether you need supplements to reach the necessary daily intake.
Keep your eye on the long-term goal: a full recovery.
An ideal recovery from a foot fracture or dislocation is one that returns you to pre-injury foot function without pain. This may not be possible in all cases, but you can do your part to get there. Remember to start slow and go slow. Putting too much stress on your foot too soon can cause problems. And if you feel pain with an activity, it’s time to rest. Your doctor will check your progress as your foot heals.
7 Tips for Recovering from a Broken or Dislocated Foot
Sarah Lewis is a pharmacist and a medical writer with over 25 years of experience in various areas of pharmacy practice. Sarah holds a Bachelor of Science in Pharmacy degree from West Virginia University and a Doctor of Pharmacy degree from Massachusetts College of Pharmacy. She completed Pharmacy Practice Residency training at the University of Pittsburgh/VA Pittsburgh Healthcare System.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 31
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
Foot Fracture Surgery | FootCareMD
What Is Foot Fracture Surgery?
There are 26 bones in each of your feet, all of which can break. There are several different types of fractures:
- Non-displaced: The bone breaks but stays in place
- Displaced: The bone breaks into two pieces that move apart from one another
- Comminuted: The bone is broken in multiple places
- Open fracture: The bone breaks through the skin after fracturing
If you injure your foot, your foot and ankle orthopaedic surgeon will take X-rays to see if you have a broken bone. X-rays will identify most fractures but some smaller and more subtle fractures may require CT or MRI scans. Not all fractures require surgery, and your surgeon will help determine how your fracture
should be treated.
If you need surgery for your foot fracture, the goals are to restore the fractured bone to its correct position, stabilize the bone in this position, encourage healing, restore function, and reduce the risk of future problems such as persistent pain,
loss of motion, and arthritis.
All foot fractures are different, but generally speaking if a fracture is significantly displaced it is likely to benefit from surgery. This is especially true if a fracture enters a joint and the joint surface is disrupted and displaced. Restoring the
alignment and stabilizing the fracture in its correct position will decrease the risk of future problems, such as pain, swelling, deformity, and arthritis.
In some cases, surgery may be appropriate for non-displaced or minimally displaced fractures if the broken bones are likely to be unstable. In such cases surgery can maintain the alignment and encourage healing in the right position.
Even some non-displaced and stable fractures may benefit from surgery. One such fracture, called a Jones fracture,
often is treated surgically in active and athletic individuals because it is likely to get them back to their activities more quickly than non-surgical treatment.
When the risks of surgery outweigh potential benefits, your foot and ankle orthopedic surgeon may recommend non-surgical treatment. This decision is based on an understanding of your entire body and pre-existing conditions. For example, if you have a
history of heart problems, your surgeon may recommend non-surgical treatment or that you see your cardiologist to determine if surgery is safe before proceeding.
Foot fracture surgery involves making an incision in the skin centered over the fractured bone. The bone is then exposed so the orthopaedic surgeon can see the fracture. The fractured bone fragments are realigned as well as possible and secured with implants
such as pins, wires, screws, and plates. After stabilizing the fracture your surgeon will stitch the incision closed, apply a sterile bandage, and place your foot in a cast, splint, boot, or post-operative shoe.
With some fractures, the surgeon can restore the alignment of the fractured bone without a large incision. In this method, the fracture is fixed with appropriate implants through one or more small incisions. This is called a percutaneous fracture fixation.
The advantages of this technique include smaller incisions, less trauma to the tissues, less disruption of the blood supply to the bone, and less pain after surgery.
After surgery your foot and ankle orthopaedic surgeon will place your foot into a cast, splint, boot, or post-op shoe. It is important to keep your foot elevated as much as possible to reduce pain and swelling. In most cases your doctor also will want
you to stay off your foot completely for 1-3
months, depending on the injury.
A few weeks after surgery your surgeon will check the wound and remove the stitches. Your surgeon may have you begin working on range-of-motion exercises of the ankle, foot, and toes. They may also refer you to a physical therapist.
Your doctor will see you at regular intervals and check X-rays to see how well the fracture is healing. Based on your fracture type and this evaluation, your surgeon will decide when you can begin to bear weight on the injured foot. They may have you
begin weightbearing with a special boot and allow you to advance slowly to your normal footwear as symptoms allow. In most cases you can expect 3-6 months or more before you return to full activity without restrictions, and up to a year before you
reach maximum improvement.
Risks and Complications
All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. To minimize the risk for blood clots, you may be placed on aspirin or a blood thinning
medication for several weeks after surgery. Unfortunately, even when on these medications, blood clots can occur post-operatively.
Potential complications of foot fracture surgery include wound breakdown, failure of the fracture to heal (nonunion), fracture healing in a bad position (malunion), loss of fracture alignment prior to healing, implant failure, persistent pain, loss of
motion, and arthritis. Smoking is a significant risk factor for multiple complications. If you are a smoker, your surgeon will discuss this with you before operating.
Foot and ankle orthopaedic surgeons are uniquely qualified to identify and treat fractures of the foot and should be your first resource when you experience a foot injury.
Original article by Dirk Gesink, MD
Last reviewed by Andrew Pao, MD, 2020
The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. The content is not intended to substitute
for professional medical advice, diagnoses or treatments. If you need medical advice, use the “Find a Surgeon” search to locate a foot and ankle orthopaedic surgeon in your area.
How To Help Your Foot Fracture Heal Well: Rocky Mountain Foot & Ankle Center: Foot & Ankle Surgeons
Whether the onset of spring has you out gardening, running, shopping, or playing soccer, the increased activity puts you at risk for a foot fracture. A broken bone can be caused by anything from overuse as you get back to spring sports, to a fall while dancing, to a crushing injury at work. So many ways to break one, but all bones—even those cut during surgery—follow the same pattern as they heal.
It begins with bleeding and inflammation where your bone breaks. This provides nutrients for repair and the clotting actually provides the first basic “structure” for your bone tissue to repair itself. This is replaced by fiber tissue and cartilage called “soft callus,” which gradually strengthens until it forms “hard callus.” Your bones continue to heal for weeks, until they regain their compact, hard form and you can start putting weight on them—which also helps in their rebuilding.
What can you do to help this process along?
- Number one: keep weight off your foot or leg. If you are constantly stressing the break, it keeps getting damaged and slows down the healing.
- Immobilization: you may need a cast or a protective boot for some broken bones, while others may only require a stiff-bottom shoe that keeps foot joints from moving.
- Icing: cold therapy can reduce pain and swelling in the first few days.
- Eat right: make sure you eat foods rich in calcium and other nutrients helpful for bone growth. We may even advise taking nutritional supplements during this time.
- Don’t smoke: smoking inhibits your circulation, which is necessary to supply the bone with building blocks to repair itself.
- Keep sugar levels under control: if you are diabetic, slow healing is often one of the complications. Maintaining even glucose levels helps.
- Follow our physical therapy recommendations: rehab is a big part of getting back to full use of your feet and legs, by strengthening muscles and reconditioning tendons and ligaments to hold the bones in place.
Our doctors have treated countless broken bones—some quick healing and many needing our surgical expertise—and we know that the part you play is crucial. We can help you get on the right track for faster healing of your foot fracture, so you can enjoy your favorite activities again. Contact our west Denver area offices by calling (303) 423-2520 or scheduling an appointment through our website.
Rocky Mountain Foot & Ankle Center
Foot fracture – 3 weeks in a boot · Virtual Fracture Clinic
This information will guide you through the next 6 weeks of your rehabilitation. Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery.
|Healing:||This injury normally takes 6 weeks to heal.|
|Pain and Swelling:||The swelling is often worse at the end of the day and elevating your foot will help. Take pain killers as prescribed.|
You may walk on the foot as comfort allows but you may find it easier to walk on your heel in the early stages.
The boot you have been given is for your comfort only and is not needed to aid fracture healing but will help to settle your symptoms.
We do not routinely follow up patients with this type of injury.
If after six weeks you are:
Please do not hesitate to contact us for a further consultation.
Picture of bones in the foot
If you are worried that you are unable to follow this rehabilitation plan, or have any questions, then please phone the Fracture Care Team for advice.
Or, if you are experiencing pain or symptoms, other than at the site of the original injury or surrounding area, please get in touch using the telephone or e-mail details at the top of this letter.
What to expect
If supplied, wear the boot for comfort and use crutches when walking.
It is ok to take the boot off at night and when resting at home and to wash.
Start your exercises straight away to maintain and improve your movement.
X Try to stop using the boot and to walk without crutches.
Start around your house first, then try outside.
You may want to wear the boot if you go on a longer walk.
Continue your exercises to regain the flexibility of your foot.
Your injury is healed. You may have mild symptoms for 3-6 months.
You can begin to resume normal, day-to-day activities but be guided by any pain you experience.
X Heavy tasks or long walks may still cause some discomfort and swelling.
|12||If you are still experiencing significant pain and swelling then please contact the Fracture Care Team for advice.|
Advice for a new injury
Cold packs: A cold pack (ice pack or frozen peas wrapped in a damp towel) can provide short term pain relief. Apply this to the sore area for up to 15 minutes, every few hours ensuring the ice is never in direct contact with the skin.
Rest and Elevation: Try to rest the foot for the first 24-72 hours to allow the early stage of healing to begin. Raise your ankle above the level of your hips to reduce swelling. You can use pillows or a stool to keep your foot up
Early movement and exercise: Early movement of the ankle and foot is important to promote circulation and reduce the risk of developing a DVT (blood clot). Follow the exercises below without causing too much pain. This will ensure your ankle and foot do not become too stiff. These exercises will help the healing process.
Early weight bearing (putting weight through your injured foot) helps increase the speed of healing. Try to walk as normally as possible as this will help with your recovery.
Medical evidence suggests that smoking prolongs fracture healing time. In extreme cases it can stop healing altogether. It is important that you consider this information with relation to your recent injury. Stopping smoking during the healing phase of your fracture will help ensure optimal recovery from this injury.
For advice on smoking cessation and local support available, please refer to the following website: http://smokefree.nhs.uk or discuss this with your GP.
Diabetic patients: If you are diabetic please contact us to discuss your boot. This is particularly important if you have problems with your skin. We can provide you with a specialist diabetic boot if required.
Footwear for your uninjured foot: We would recommend choosing a supportive shoe or trainer with a firm sole for your uninjured foot. You will notice that the boot you have been given has a thicker sole, by matching this height on the uninjured side you will reduce any stress on your other joints.
Initial exercises to do 3-4 times a day
Ankle and foot range of movement exercises. Repeat these 10 times each.
- Point your foot up and down within a comfortable range of movement.
- With your heels together, move your toes apart, as shown in the picture.
- Make circles with your foot in one direction and then change direction.
90,000 Treatment of complications after fractures
We will tell you about the treatment of complications after fractures, which include: pseudarthrosis, non-union fractures and chronic injuries, as well as incorrectly fused periarticular fractures.
In the clinic “Scandinavia” there is an opportunity to examine
and promptly treat patients who have either long-term non-healing fractures, or complex joints on the background of surgical interventions, or old or incorrectly fused fractures.
What is done in this case? Firstly, the clinic has the ability to examine the patient: CT, MRI, X-ray and everything else. Secondly, the clinic has a sufficient set of metal structures. In addition to the fact that the clinic has the ability to treat emergency patients with a recent trauma, it is also possible to treat and perform operations on patients who have long-term consequences or problems after injuries. These include: pseudarthrosis, non-fused fractures, improperly fused fractures, fractures of metal structures on non-fused fractures.The problem is that any fracture, growing together, goes through certain phases. Why does a false joint arise? Or the fragments are not properly positioned – there is no contact between the fragments, or surgical treatment was performed, but there was insufficient reduction, or other technical problems.
There are fractures, the localization of which will not greatly affect the further life and function of the limbs, with which, in principle, nothing can be done, even if they have not fused correctly. Well, perhaps there may be a cosmetic defect.And there are fractures (these mainly include periarticular and intraarticular fractures), which cannot be left in this form and something must be done with them in order for a person to live fully functional further.
The doctors of the clinic also operate on pseudoarthrosis, and with bone grafting, using the same newest metal structures and techniques that are used all over the world. Also in the clinic, incorrectly fused fractures are operated on,
replacement of metal structures with correction of the limb axis, with correction of the position of fragments inside the joint.There are intra-articular fractures requiring arthroplasty that cannot be repaired with simple methods. In this situation, endoprostheses of the knee, hip, and shoulder joints are used, followed by rehabilitation in a clinic, which is possible until complete recovery.
Periodically, patients with chronic injuries who are in such a state come to the clinic: it has not grown – has not grown together, it is not clear, there is no support, for example, on the leg, if it is a fracture of a large bone, tibia or near the femoral neck.They are mostly bedridden, often city clinics refuse to help them, because they do not have the opportunity to provide sufficient treatment for comorbidities. These are mainly elderly patients and patients with cervical fractures, pertrochanteric fractures, even with chronic ankle fractures. They require surgical treatment, but under the conditions of a very qualified anesthetic team and rather serious rehabilitation. This is what the doctors of the clinic do: they synthesize these fractures, put everything in place, as it should be.Sometimes this is due to technical difficulties, but the clinic has an orthopedic table that helps with this, and an X-ray unit, with which all actions are controlled during the operation.
Even if it was a very old fracture, doctors try to put the patient on his feet literally the day after the operation. The implants and techniques used allow this to be done, and therapeutic and anesthetic support makes it possible to activate them very quickly.
There is also such a problem as false joints – these are non-union fractures, the non-union of which lasts more than six months. That is, we are talking about a double-triple period of a typical fusion, if during this time the fracture has not healed, a false joint is formed at this place. The problem is that by itself it will never grow together after that, it will always be mobile and will cause inconvenience.
Such problems arise both after previous operations and without surgical treatment.The main task in such a situation is to create conditions for fusion. This is the stabilization and irritation of the fracture zone or the transplantation of one’s own bone there in order to stimulate the healing of the fracture. Such operations have been performed in the clinic many times with good results and with early rehabilitation.
One of the consequences of injuries is improperly healed fractures. This occurs either due to incorrect immobilization, or in general due to failure to see a doctor about a fracture.It happens that with an inadequate load, the metal structure breaks down, which is fixed to the fracture, and the fracture heals in the wrong position. If this is a supporting bone (for example, a loading leg), it is impossible to live with it, this is a curvature of the limb, which leads to problems above and below the fracture. In this situation, surgery is required. If the metal structure was previously installed there, it is removed, the axis of the limb is restored with minimal loss of local tissues and is also fixed in this way
in a way so that you can start loading this limb as early as possible.
The greatest danger is posed by improperly fused periarticular fractures, because they ultimately lead to severe arthrosis. Even at a young age, with an incorrectly fused fracture of the leg, arthrosis of the ankle and knee joints appears, so such things must be corrected. Maybe outwardly it does not look so scary, but after 3-5 years problems will begin in the fracture zone above and below. The operation is carried out precisely in order to quickly rehabilitate and continue a full life further.
Date of publication: 04/27/16
90,000 How to heal a fracture 4 times faster
Russian scientist Arnold Popkov, Chief Researcher of the Scientific Center “Restorative Traumatology and Orthopedics” named after Academician G.A. Ilizarov, published in the German publishing house Palmarium Academic Publishing monograph devoted to new bioactive implants with a coating that accelerate fracture healing. The research was supported by the Russian Science Foundation (RSF) grant .
Cells and the roads they choose
Bone grows together thanks to the division of living and active stem cells that have not “determined their fate” completely since the time of embryonic development. How does a bone cell make its way to this state? Its development is similar to how we choose a profession: first, a humanitarian or mathematical class, then a faculty, then a department or department, obtaining a specialty, and so on.
Initially, during the first few cycles of division after fertilization, not a single cell of our future body “knows” which path it will take, and “all roads are open to it”.
As the embryo develops, a more complex structure is formed from simple and identical cells – three germ layers, endoderm, ectoderm and mesoderm, which in the future will give rise to organ systems. The mesenchyme is formed from the mesoderm. The cells of the mesenchyme are already different from the rest, but they are very similar to each other, and it is not yet known which of them will choose the “profession” of blood cells, who will become a muscle cell, and who will become bones. A group of cells stands out from the mesenchyme that do not yet want to make a decision, limiting their future choices. Further, the organism goes through many more stages of development, at each of which the cells are determined more and more, until they finally choose their “profession”.
Stem cells, as well as this group of “indecisive” mesenchyme cells, remain in a frozen state of “eternal childhood”, so that in the event of the death of differentiated cells in the body, finally make their choice and take their place.
At first, such cells are called osteogenic (literally – producing bone).They can produce growth factors by stimulating bone marrow formation. Then they differentiate again, becoming osteoblasts, cells on the inner surface of the periosteum. Angular and actively dividing osteoblasts produce collagen proteins and components of loose intercellular substance. Then the osteoblasts lose their ability to divide, “retire”, harden and become osteocytes. It is these mesenchymal osteogenic cells that play the main role in fracture healing.
ByRobert M. Hunt Formation of bone tissue by osteoblasts
“Fracture, lost consciousness, woke up – plaster”
In Russia, more than 13 million people a year are injured, the consequences of which are the most common cause of disability among citizens of working age. An additional risk factor is congenital diseases of the musculoskeletal system. In Russia, for every 10 thousand newborns, there are 219 people with such disorders.
For the treatment of fractures and post-traumatic complications, special implants are used – inserts made of metals that help to connect broken bones, fix and maintain them in this state until they heal.The material of the implants itself can affect healing (consolidation) in different ways, but none of the metals known to modern doctors can accelerate it.
Therefore, over the past 100 years, with all the development of medicine, the timing of fracture healing has not changed.
Kurgan scientists have proposed to combine the metal base of the implant with a coating of hydroxyapatite – a substance based on calcium and phosphorus present in the bone in the form of nanoscale crystals. Hydroxyapatite promotes osteogenesis and stimulates osteogenic cells, but in itself it is too fragile material for implantation (flexibility of bones is given by organic components, which are replaced with calcium compounds more and more with age, which makes bones more fragile in old age).
Therefore, it was decided to combine a biotolerant (that is, not harming ostenosynthesis, but not improving it) titanium alloy and a rough bioactive (stimulating bone to regenerate) nanohydroxyapatite coating.
The developed technology of mathematical 3D modeling makes it possible to form an implant individually for each patient, taking into account the total bone density, the number of channels, pores and vessels, and to implant it into the internal cavity of the bone (intramedullary). Controlled arrangement of hydroxyapatite nanocrystals allows “mimicking” individual bone roughness.Materials are made after tomography using selective laser sintering technology, and then a layer of hydroxyapatite is applied to them.
“The use of stimulation methods based on intramedullary implants with ceramic nanohydroxyapatite coating guarantees a positive treatment result and a real reduction in the time of osteosynthesis in bone fractures by 2–4 times,” says the author of the monograph, Dr. med. Arnold Popkov.
– Simplicity, availability and economic feasibility of use at the earliest stages of medical evacuation (district hospital) are especially important during the transition of the Russian Federation to the compulsory medical insurance system.New technologies easily fit into the scope of basic trauma care and assistance provided on urgent grounds and in a planned manner in the rehabilitation treatment of the consequences and complications of trauma, financed from the CHI funds. ”
The author adds that his work can become a contribution to import substitution and allows the production of implants in Russia that are not only comparable to Western counterparts, but even surpassing them in terms of the healing rate.
90,000 Fracture of the patella – A.K. Eramishantseva
Fracture of the patella is typical for people in old age and is usually the result of street injuries. This pathology accounts for 1.5% of the total number of fractures.
Symptoms of patellar fractures
This fracture has a rather pronounced symptomatology. This is a visible swelling in the area of the knee joint, a sharp pain that the patient complains about, perhaps even visualization of a gap between the fragments, a pronounced crunch of bone fragments and, in some cases, blood in the knee joint (hemarthrosis).Patients complain of increased pain when bending the knee, and extension is impossible or significantly limited.
If the fracture is not displaced, then the patient can still walk, albeit with severe pain. With a fracture with displacement, walking is completely excluded.
Causes of patellar fracture
This fracture occurs when the kneecap hits a sharp or hard object or falls on a bent knee, which qualifies as a direct injury.Indirect injury can be triggered by a sudden contraction of the quadriceps muscle. In some cases, a mixed fracture mechanism is noted, with indirect and direct trauma.
Quite often, this type of fracture is observed in combination of damage to the lateral and flexion apparatus. Tendon rupture is characterized by a pronounced divergence of fragments in the patella.
Treatment of patellar fractures
This type of fracture without displacement is treated conservatively, by fixation with a plaster splint.The fixation period varies from two to three weeks, when the patient is allowed to walk on crutches. After the plaster is removed to the patient, courses of physiotherapy exercises, electrophoresis or UHF are prescribed. The patient returns to full life in one and a half to two months.
In case of a fracture with displacement, surgical intervention is indicated, using a variety of techniques, including, if necessary, muscle-tendon plasty. The limb must be immobilized for at least a month after surgery.After that, the patient is prescribed physiotherapy and therapeutic exercises. The terms of full recovery of the patient’s physical activity with such an injury increase up to three months.
Diagnosis of patellar fracture
The diagnosis of this fracture is established by the traumatologist of our center based on the clinical picture and the indications of radiography. As an additional study, MRI can be prescribed.
It will grow together – it will not grow together … What is insidious about a hip fracture
Article from the newspaper: AiF Health No. 40 03/10/2017
It is believed that a hip fracture is an injury that occurs exclusively in old age.But it turns out that this is not at all the case.
More and more often, young and middle-aged patients with this diagnosis are admitted to traumatologists and surgeons. Why is this happening?
A word to our expert, traumatologist-orthopedist of the GKB im. V.V. Veresaeva DZM Dmitry Khryapin .
Source of trouble
There are many reasons why this type of trauma is increasingly affecting people who are still quite young. A diet in which there are no calcium-rich foods, vegetables and fruits, and fast food prevails, a sedentary lifestyle, there is no adequate physical activity – all this undermines our frame.As a result, bone and muscle tissue, as well as joint tissue, suffer. And there it is not far from the fracture.
The mechanism of injury to the hip joint is usually simple: fell, hit sideways, and could no longer stand on his own. In elderly, sedentary people, a fracture can occur even without falling. Trauma usually occurs while walking when the patient suddenly experiences severe pain in the joint.
Unlike other types of fractures in the hip region, which usually heal, the femoral neck is restored very poorly, since it has a different anatomy of the blood supply. After an injury, blood practically does not enter the fracture zone. In addition, the nutrition of the femoral head is disrupted, aseptic necrosis or coxarthrosis develops. In these cases, the patient’s life is at risk. Especially often, severe complications occur in old age, when the process of tissue repair suffers.
Will grow together – will not grow together …
It is believed that the likelihood of healing a hip fracture directly depends on the person’s age. The younger the patient, the higher this probability.For example, if such an injury occurred in an 80-year-old patient, then doctors can be 80% sure that the bone will not heal. And if this is a 30-year-old woman – then by 30%, which is also a lot. Therefore, in the event of a hip fracture, doctors prefer to undergo surgery.
In young people, operations, as a rule, lead to bone fusion and return to normal life, however, after the operation, a long recovery period is required – massage, gymnastics, walking training. In the elderly, unfortunately, even surgery does not always help.
Movement is life
Why is it much more difficult for older people to overcome injuries? The fact is that physical activity decreases with age. Without load, the bone weakens, becomes fragile, blood circulation in the joint area is reduced to a minimum, so it is enough for an elderly person to stumble slightly to get a fracture.
All this means that maintaining mobility at any age, including the elderly, is the key to minimizing such injuries. Physiotherapy, gymnastics, as well as proper, nutritious nutrition are undoubtedly the key to longevity.
Prevention of hip fracture
Recommended for young and middle-aged people :
o Swim . But you should not abuse jogging and especially jumping on a trampoline – these sports are called joint killers by traumatologists.
o Keep track of body weight .
o Perform exercises on simulators aimed at reducing adipose tissue and increasing muscle mass in the area of the hip joint.
90,000 Alcohol slows down the healing of fractures – Rossiyskaya Gazeta
Many injuries and bone fractures, including complex ones, are received by people in a state of alcoholic intoxication. Whether it’s due to a car accident, a fall, an accident at work or a gunshot wound, alcohol is always an additional risk of fracture. But it turns out that it also affects the healing process of broken bones, slowing it down. A report on this topic was presented at the annual conference of the American Society of Orthopedic Specialists in Baltimore (USA).
Researchers have studied the effect of alcohol on the healing of bone fractures in laboratory mice. One group of mice received a dose of alcohol equivalent to three times the US legal limit for driving. Recall that in different states for drivers over 21, the permissible dose of alcohol while driving is approximately 0.5-0.8 ppm, which is equal to the intake of 60-100 ml of vodka. In our reality, many consider such a dose to be almost therapeutic, not to mention more.
So, half of the poor mice were soldered “while driving”, and their sober relatives received equal amounts of saline, that is, water with salt diluted in it.The experiment showed that in drunken mice, callus (the tissue that forms at the ends of broken bones) contained less calcium and other minerals. In addition, they had impaired bone cell function, as they had oxidative stress. It also lowered the level of an enzyme that can reduce this stress.
During the healing process, immature stem cells migrate to the fracture site, which must then turn into normal bone tissue. Two proteins are normally involved in this process.In the group of mice that received doses of alcohol, the levels of these proteins were also significantly lower. As a result, fractures healed in them much slower and worse than in sober animals.
Researcher Roman Natoli of the Jesuit University of Loyola (Chicago), who presented a paper at the conference, suggests that two approaches can be used to reduce the negative effects of alcohol on healing. First, in addition to inject into the victim’s body stem cells that can specialize in bone tissue.Second, add antioxidants to them that fight oxidative stress.
Perhaps the use of these funds will speed up the healing of fractures in teetotalers, suggested Dr. Natoli. For some reason, a possible third option – to exclude alcohol during treatment – was out of the question, although it might have been the most effective.
cost of joint replacement surgery in Moscow
Statistics, as you know, knows everything, and it is statistical studies that claim that a hip fracture is an injury to which the elderly are most susceptible.
The most common cause of this injury is falling on the street in ice. Among patients with this severe injury, more than 70% are women, of retirement age, and this fact can be easily explained by the fact that it is in this category of patients, under the influence of age-related changes in hormonal status, osteoporosis most often occurs, which is manifested by impaired absorption of calcium by the body, due to which bones and become very fragile. In women, after the end of menopause, fractures of various bones of the skeleton can occur even with awkward movement, the more the risk of fracture increases many times with a direct injury to the reed area (with a normal fall).
Fracture of the femoral neck is a very dangerous injury and its danger can be explained by a combination of several factors:
The femur is the largest bone of the human skeleton, in case of a fracture of which not only the integrity of the bone itself, but also of the surrounding tissues is inevitably violated, and as a result, patients usually develop painful shock and internal bleeding.
A hip fracture is a type of fracture that has to be treated primarily by surgery, and further rehabilitation requires many months of bed rest.
It is the rehabilitation period that is very often complicated by the development of pneumonia, bedsores and deep vein thrombosis, both in the injured and in the healthy leg.
Symptoms of a hip fracture
As with other types of fractures, the most common complaint of patients will be very severe pain and dysfunction of the limb. A patient with a hip fracture usually tells the doctor about the appearance of numbness in the foot of the injured leg, often the patient himself notices that his injured leg becomes shorter than the healthy one.Often the patient takes a forced position, in which his injured limb is turned outward as much as possible. To clarify the diagnosis, and most importantly, to determine what kind of operation the patient will need, it is imperative to perform an X-ray of the upper part of the injured limb, with the obligatory capture of the pelvic bones and the upper part of the femur on the film.
Treatment of hip fracture
Depending on the place of the immediate location of the fracture itself, it is possible to carry out arthroplasty of the joint with an intra-articular location of the fracture or osteosynthesis of the femur with an extra-articular fracture of the femoral neck.They try not to delay the operation for a fracture of the femoral neck, since with intra-articular fractures due to compression of the surrounding tissues, aseptic necrosis of the femoral neck may develop.
The period of postoperative rehabilitation in patients operated on for a hip fracture takes many months, and often stretches for more than six months. During this period, due to constant bed rest and limited motor activity, patients often develop congestive pneumonia, pressure sores, and deep vein thrombosis of the leg, which can lead to the detachment of a blood clot and its drift into the lungs, which can cause death due to thromboembolism. pulmonary artery.
It is for the prevention of these complications after a hip fracture that first passive and then active movements in the injured leg are allowed, early getting out of bed, bandaging the limbs with an elastic bandage, a complex of exercise therapy and massage.
Ankle joint swells and hurts: causes, diagnosis, how to treat
The ankle joint plays an important role in the mobility of the whole body. This segment of the musculoskeletal system connects the foot to the lower leg, making them one whole.When any of the parts are damaged due to trauma, the ankle joint swells. It hurts, so you need to know exactly how to treat it.
To identify the causes of swelling of the limb in the ankle, it should be understood that they can have a different nature of origin:
- Background pathologies;
- Injuries, dislocations, fractures, sprains;
- Rheumatic pathologies.
The main negative factors also include:
- Plantar fasciitis;
- Vascular diseases;
- Endocrine diseases
- Infection of soft tissues by pathogenic microorganisms;
- Decreased venous tone;
- Insect bites;
- Taking medications;
- Excessive loads on the feet.
The following factors have an equally negative effect on the ankle, in which swelling of the leg occurs, observed in both the ankle and the foot:
- Use of shoes with heels or flat soles;
- The nature of the work;
- Weight lifting;
- Poor nutrition;
- Delayed treatment of diseases;
- Cardiac pathologies or high blood pressure, impairing the outflow of accumulated fluid from the tissues.
When a patient’s legs swell for a long time, especially at the bottom of the foot or lower leg, it is necessary to consult a specialist.With ankle inflammation, you can visit an orthopedic traumatologist, surgeon, if necessary, you may need to consult a nutritionist. During the initial examination of the patient, the doctor conducts a visual examination and prescribes laboratory and instrumental studies:
- Blood biochemistry.
If the results show that the presence of such changes is a consequence of background pathologies, you will need to contact a therapist, endocrinologist, gastroenterologist.
The essence of wellness activities
Usually a person, when his leg swells and hurts for a long time in the ankle area, having tried all home remedies, does not know what to do. He begins to see a specialist. After finding out the causes of the swelling of the leg, the doctor chooses effective ways to treat these disorders.
Treatment of arthrosis or arthritis at the earliest possible stages is carried out by means of:
- Physiotherapy procedures;
- exercise therapy;
- Manual treatment.
The main stage of therapy for swelling of the ankle or foot, if the cause is an injury, is the immobilization of the diseased joint, as well as reducing the load on it. In this case, it is necessary to allow time for the joint to recover and rest.
If a similar problem is associated with excess weight, the patient will have to reconsider their diet. Excessive loads support the development of the pathological process, therefore, when there is ankle edema, the causes of which lie precisely in obesity, treatment will be aimed at minimizing the loads until complete healing.
The use of medications is necessary to block the inflammatory focus and pain spasms.
For this purpose the following applies:
- Antibacterial medicines;
- Nonsteroidal anti-inflammatory drugs;
- Medicines for local exposure.
With the help of external agents – ointments or gels, you can remove puffiness, improve blood supply, and get rid of pain. Conservative therapy of ankle pathologies is based on the following health-improving physiotherapeutic measures:
- Baths based on radon and hydrogen sulfide;
- UHF therapy;
- Mud therapy;
- exercise therapy.
The set of exercises for the patient is selected individually, taking into account the root causes of the onset of unpleasant symptoms.
With the help of regular training, you can quickly restore the lost function of the diseased joint.
Some experts believe that a pathology such as arthrosis can be cured through only therapeutic exercises, without the inclusion of additional tools in the therapeutic base.
Causes of pain in the foot under the toes when walking
Therapy for edema appearing on the joints of the foot involves the use of the following techniques:
- Improvement of venous tone and blood microcirculation;
- Extraction of exudate;
- Improving the permeability of the surface of blood vessels;
- For joint injuries – cleaning the wound, restoring bone fragments to their natural state.
It is the last item on the above list that is the first priority for edema due to trauma.
No other medicines will help eliminate the pathology. With a closed type of fracture, it is necessary to eliminate the foot subluxation, match the fragments, and reliably fix the injuries locally with a plaster cast.
If necessary, use a more reliable fixation with the Ilizarov apparatus or metal plates
Drug therapy options
When the legs swell in the ankle area, the doctor may prescribe the following drugs to the patient:
- Chondroprotectors in the form of drugs Ortoflex and Teraflex or Structum and Alflutop).Medicines are recommended for the restoration of cartilage in the joints. Such remedies are prescribed for a long time. The course can be up to six months.
- Diuretics in the form of medicines Ketazone, Benemide or Furosemide. Medicines reduce congestion by allowing excess fluid to drain out of the body quickly.
- Medicines that restore blood circulation in the inflamed area (Actovegin, Heparin).
- Non-hormonal anti-inflammatory drugs (Ketoprofen and Ibuprofen or Diclofenac and Meloxicam).They are recommended when the ankle hurts and swells due to arthrosis or arthritis.
- Local anesthetics (Anestezin, Novocain, Lidocaine).
- Hormonal drugs for intra-articular injection (Hydrocortisone). With the help of these medicines, the inflammatory and destructive process in the joint is inhibited. The course is required no more than 1-2 times a year. These drugs relieve the patient’s condition and reduce severe symptoms.
An approximate treatment regimen is as follows:
- If the swelling appears due to damage to the joint, it must be fixed by first adjusting it in case of dislocation or reassembling in case of a fracture.Depending on the complexity of the injury, it is recommended to use a rigid fixation or apply an elastic bandage.
- The purulent substance and blood accumulated in the joint must be removed, after which antibacterial drugs are injected into the space.
- Along with this group of drugs, steroid hormones are periodically delivered to the articular cavity (Diprospan, Kenalog).
- An excellent medicine for traumatic and inflammatory edema of the ankle is a medicine with horse chestnut fruits (L-lysine escinate).It is administered by drip inside the vein.
- Another remedy – Aescin gel. It is used externally, applied to the skin in the projection of the articulation. These activities will remove edema in just a day.
To improve blood microcirculation in blood vessels, soft tissues and muscles, the following drugs are administered through droppers:
With injuries and inflammation of the ankle, venous blood flow often suffers.Constant influences change the properties of the venous walls, resulting in weakening of the vein valves. To strengthen them use:
All described drugs are taken as tablets. Long-term therapy is required to relieve unpleasant symptoms with the aforementioned drugs. Ankle edema, characterized by an inflammatory nature, is blocked with external anti-inflammatory pharmaceutical ointments:
All drugs are recommended for use with the approval of a physician.
Ankle edema can be treated with non-traditional methods.
Good results can be achieved when using folk remedies for mild arthrosis, gout, arthritis.
Garlic is one of the most popular remedies. It contains a sufficient amount of antiseptic substances that provide a healing effect.
For therapy, you need to take several small cloves of this vegetable, chop, mix with eucalyptus leaves, add pork fat, first melting it.It is necessary to treat the area of the inflamed joint with ointment. Perform the procedure at night.
Onions are also classified as effective products in the fight against inflammatory processes. Grind the vegetable with a grater, mix it with sugar. The mixture must be fixed on the leg using a bandage for this purpose. The drug is best used after its preparation.
Many healers recommend using elecampane root for such phenomena. An alcoholic tincture is prepared from this plant.Use a composition for external exposure.
Golden mustache tincture is also recommended for the treatment of leg edema. It perfectly relieves a painful attack and blocks the inflammatory process. For the recipe, you will need to chop the leaves, pour them with alcohol, insist for a week.
Use medicine for compresses. You can also make a warming bandage with baking soda, honey, and mustard powder. All products should be taken in equal proportions. Apply the mass to the affected joint.
The duration of the treatment procedure is 30 minutes.
Copper powder will help relieve swelling. It can be obtained from a coin using a file for this purpose. Copper must be combined with egg yolk or milk (proportions 1:10). 1 tsp drink this remedy twice a week until complete recovery.
For medicinal purposes, eggshells are used in folk medicine. It is obtained by boiling eggs. The shell should be crushed in a coffee grinder; this powder is recommended to be added to food.Such a remedy will make up for the lack of calcium in the patient’s body.
If a patient is diagnosed with arthrosis or arthritis, he is recommended to undergo a course of massage. To enhance the effectiveness of this procedure, it is advisable to use herbal tinctures. Traditional medicine can only be used in the form of additional recreational activities. The primary treatment must be prescribed by a physician.
Diet should be used as an additional measure.Proper nutrition ensures a quick recovery. With the help of this item, the problem of the patient’s excess weight is solved and the affected tissues are restored. If the ankles are swollen, the patient is advised to reduce the consumption of kitchen salt. You should also refuse to drink:
- Tea too strong;
- All kinds of carbonated drinks.
Minimize your consumption of baking and pastry “goodies”. Exclude from diet:
- Fatty dishes;
- Spicy and smoked products;
- Canned food and sausages;
- Citrus fruits.
When there is ankle swelling, it is best to eat well. Allowed to be used in the diet:
- Greens – dill, parsley, cumin;
- Fruits and vegetables;
- Lean meats and fish.
Vegetables, herbs and fruits will help to quickly fill the lack of useful minerals and vitamins in the body. Seaweed will replace salt, and flaxseed oil will help eliminate inflammation in the body. Dishes should be used boiled or baked. However, before starting diet therapy, you need to consult a specialist.
First steps in case of injury
If the ankles swell due to injury (bruise, sprain) or high loads on the legs, first aid should be given at home immediately. First of all, it is necessary to free the lower limb from clothes and shoes. Then you need to lie on your back and raise your leg. It is advisable to put a hard roller or pillow under it – this will help slow down the process of swelling of the limb.
Apply a cold compress or ice to the injured leg, leaving it for 20 minutes. The compress should not be kept further, so as not to provoke hypothermia of the lower limb. Apply an elastic bandage, fix the foot in a motionless state.
Perform such actions immediately after damage and continue the procedure for 24 hours, repeating them every 3 hours.
The ankle joint swells and hurts: how is it treated?
Swelling and pain in the ankle joint make you say goodbye to the port and fashionable shoes for a while.Of course, everyone wants to get rid of this condition as soon as possible, but not everyone goes to the doctor for help, while doing self-medication.
Ankle joint structure
It is formed from three bones, namely the tibia, tibia, talus. They are all connected by tendons. The joint has a block-like shape.
The ankle joint is subjected to enormous dynamic and static loads throughout the day. This puts him at greater risk of getting pathological changes, which are characterized by pain, swelling, redness, and sometimes immobility of the limb.
Causes of pain and swelling in the ankle joint
The development of arthritis can occur after rheumatism, gout, various injuries of the ankle joint, joint inflammation and other diseases can also give rise to the disease.
During arthritis, swelling of the periarticular tissue is characteristic. This occurs, due to a deterioration in capillary permeability, intra-articular fluid accumulates, in which traces of blood or purulent formations are sometimes present.
Infectious or autoimmune diseases can also lead to the development of ankle arthritis:
The cause of its development is bacterial invasion.
The development of inflammation is promoted by skin psoriasis (a chronic inflammatory disease). In psoriasis, there are red, scaly patches on various parts of the body.
In this form of the disease, the inflammation is protracted, and the immune system suffers.
The ankle joint is able to swell quickly enough and without any visible preconditions. The sensation of pain in the ankle increases significantly at night, and throughout the day the pain is not so intense.
The following criteria are characteristic of the disease:
- Poor metabolism
- Failures in the production of urogenital acid
- Inflammation of the big toe and even the entire ankle
This is because too much salt builds up in the joints and blood.She does not have time to hatch. This becomes the reason for the painful and swollen condition of the foot.
Cartilage wears out, making it difficult for the joint to function properly. After the disappearance of the cartilage, the bones begin to wear out.
As a result, muscles and ligaments are weakened. Arthrosis reduces the strength of the ligamentous apparatus, makes the joint unstable, and sometimes becomes the starting point for new injuries or inflammation.
Tendinitis and fasciitis
Fasciitis is an inflammatory disease of a thick strip of connective tissue.This tissue is called fascia. The strip covers the bones of the feet. Fasciitis is accompanied by pain and inflammation of the ankle joint.
With increased and constant physical exertion of the heel, the disease is more common. Also, overweight people, gait defect, abnormal structure of the feet suffer from this ailment.
Choose the right and comfortable shoes, otherwise you are at risk of developing fasciitis
Tendonitis – inflammation, deformation and destruction of tendon tissue.It is accompanied by constant excruciating pain in the ankle, inflammation, swelling, crunching.
The reasons for the development of the disease can be age-related changes, heavy physical exertion, trauma, metabolic disorders, tendon infections, and taking medications.
Sprain and rupture of ligaments
Due to hemorrhage during stretching, the edema appears rather quickly. When feeling the ankle, a sharp pain appears. When the ligaments rupture, the permeability of small blood capillaries increases, the plasma enters the tissues.
The injury is accompanied by pain and swelling for about three weeks, making it difficult to move. The tear weakens the ankle, putting it at greater risk of injury.
Microcirculation in soft tissues is impaired, muscles become edematous, blood flows into soft tissues and joints, blood outflow through veins is impaired.
With a fracture of the ankle, not only edema occurs, but also pain in the ankle. Long-term edema can lead to soft tissue lymphedema.
Vascular edema sometimes develops as a result of thrombophlebitis or serious diseases.
Infections are a common cause of ankle swelling. Infections can be different: soft tissue (cellulitis), viral and bacteriological. It is treated with medication, in rare cases, surgical intervention is required.
Diseases of internal organs
- Varicose veins. The first symptoms are heaviness in the legs, fatigue, dilated veins, pain.
- Thrombophlebitis (formation of blood clots in the lower extremities).
- Heart disease. In addition to swelling and pain, symptoms such as cyanosis of the legs, shortness of breath, high or low blood pressure, fatigue, chest pain are characteristic.
- Liver pathology. Along with edema, there is itching, impaired brain activity, weight loss.
- Disorder of the thyroid gland. Symptoms such as drowsiness, fatigue, weight gain can be added here.
Menstruation, snake or insect bites, poor sleep, overweight, alcohol abuse can also cause swelling and pain in the ankle joint
People with ailments such as:
are at risk of swelling and pain in the ankle joint
- Diabetes mellitus
- Varicose veins
Even the most experienced doctor cannot always determine the exact cause of the swelling and pain in the ankle joint.
For this purpose, they resort to modern diagnostic methods such as:
- computed tomography
Consult a doctor, he will be able to establish the cause of the disease and prescribe an effective and correct treatment.
Ankle vascular edema is treated with vasodilators and drugs that increase venous tone.
Apply absorbable gel to the shin area. In a severe case, hirudotherapy may be prescribed, which involves treatment with leeches.
In case of subluxation , for a start, the doctor tries to return the joint to its initial position by manual methods. Then they put on an elastic bandage or ankle brace, this protects the joint from repeated dislocation. You can take it off only during sleep.
Osteoarthritis is treated with intra-articular injections of corticosteroids. Three injections are given, each two to three weeks apart.
Rarely use non-steroidal anti-inflammatory drugs. Treatment should not last more than a month.
The most common methods of treatment are thermal procedures, laser, magnet, bile compresses. Along with this, the doctor prescribes chondorotectors, vasodilators, intra-articular injections of hyaluronic acid and special exercises.
In case of fractures, the wound is treated first, the subluxation of the foot is eliminated, the broken bones are made up and a plaster cast is applied to the ankle.Sometimes, for a more reliable fixation, metal plates or the Ilizarov apparatus are used.
If pus or blood has accumulated in the ankle joint, they will be removed first, after which antibiotics will be administered
Treatment of swelling and pain in the ankle is aimed at increasing venous tone, improving microcirculation, decreasing vascular permeability, and removing exudate.
- Instead of antibiotics, they can prescribe steroid hormones (Diprospan, Kenalog).
- To improve the microcirculation of blood in muscles and tissues , droppers are placed with Trental, Curantil and Pentoxifylline.
- After injuries, preparations containing the fruits of horse chestnut help well. L-lysine aescinate is administered by drip, Aescin gel is applied directly to the skin. This helps to get rid of puffiness in a day.
- Veins and valves are injured after his injuries. A long course of tablets Phlebodia, Detralex, Diosmin, Vasoket will help to strengthen the veins.
- Various gels and ointments (Nise, Ibuprofen, Diklak) also help well.
Only an experienced specialist can prescribe the correct treatment
Along with taking medications, the specialist will recommend physical therapy and physiotherapy measures.
During this period, a special diet should be followed so that the cartilage tissue can recover faster.
To avoid swelling of the ankle joints, the following preventive measures are recommended:
- Keep track of your weight
- The older generation should eat foods containing cartilage tissue and collagen (jelly, seafood, jellied dishes)
- Eat less canned tomatoes and peppers, sorrel, hot spices.
- Observe the correct drinking regime
- Do not abuse alcohol and cigarettes
- Choose comfortable and orthopedic shoes. It shouldn’t make you uncomfortable. Don’t wear high heels.
- Increase your calcium intake. This will help to strengthen the bone tissue.
If the above preventive measures still lead to swelling, contact a specialist
Ankle swelling and pain
- Diagnostics and treatment
- Most important
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The ankle joint is one of the few joints in the human body that carries a huge load.
This fragile joint, in fact, undergoes enormous trials every day, because a person takes thousands of steps, and his body weight – normal or overweight – is carried primarily by the ankle.
It is not surprising that the ankle joint swells and hurts when exposed to various pathologies.
The ankle joint is formed by three bones – peroneal, tibial and talus.
Thanks to tight ligaments and tendons, the ankle elements are tightly connected to each other, thanks to which the joint performs powerful work to move the human body.
At the same time, the connective tissue elements are quite mobile and allow the joints to actively move – this can be seen if you try to rotate the leg in the ankle.
To understand why the leg hurts at the bottom in the ankle area and how to treat discomfort, it is necessary to establish the cause of the pathology. Doctors note that the most common causes of joint pain and swelling in the ankle are:
- sprain of the ligamentous apparatus;
- joint fracture;
- dislocation or subluxation;
- deforming arthrosis;
- circulatory pathology;
- pathology of the kidneys and heart.
As you can see, the first causes of ankle swelling belong to the traumatic group of factors, and the rest are triggered by the development of various diseases that negatively affect the ankle joint. When diagnosing pathology, it is important to timely eliminate the destructive factor and begin treatment.
Ankle sprain is a closed joint injury, as a result of which the ligaments are exposed to a negative factor and stretch beyond their physiological limits.Usually, a sprain does not lead to a tear or a complete rupture, however, the injury is very painful and can permanently disable a person. The most important thing is to provide first aid correctly.
REFERENCE! In most cases, the ankle turns inward – in 8 out of 10 cases of sprains, the leg receives inversion damage.
The main cause of sprain is congenital weakness of the ligamentous apparatus or acquired due to poor physical activity of a person.And also the ligaments are stretched when injured, they can be damaged as a result of existing arthrosis, flat feet or clubfoot. A common cause of injury is improperly laced athletic shoes or equipment.
A characteristic symptom of a sprain is swelling of the ankle and severe pain in the leg at the time of injury. Patients can clearly identify when the pain appeared and what it was associated with.
When a blood vessel ruptures, a bruise appears on the ankle, and deep hematomas appear after a few days.The inner surface is rarely affected, usually bruises appear on the outside.
The mobility of the joint is limited due to pain and swelling, the leg can take a forced position – doing all the movements of the limb is very painful.
Sprains are of three degrees. At the first degree, the pain is moderate, patients can move independently or with support on something. The joint is stable, and patients even remain able to work and do not require hospitalization.
With the second degree of injury, the pain is more pronounced and a hematoma is already attached.Patients cannot walk due to severe pain, and the joint itself may become unstable. Symptoms of the third degree are similar to the second, but external swelling and pain are more severe.
Patients are disabled.
If the ankle is swollen, it is necessary to raise the leg to an elevation and provide it with rest to stop the development of swelling. Cold must be applied to the injury site – this also resists edema. An elastic bandage is applied to the ankle joint and the patient is taken to the clinic for examination.
X-ray images or MRI results play a decisive role in making a diagnosis. Treatment for sprains is predominantly conservative – an elastic bandage is applied to the ankle, physiotherapy is prescribed, and physical therapy exercises are recommended to strengthen the muscles.
Fracture of the ankle joint is one of the most common injuries of the lower limb, with more frequent injuries to the ankle in winter, when patients are injured by slipping on icy paths.In most cases, an ankle injury pulls the ligaments and joint capsule of the articulation of one leg with it, but the most severe injury is a fracture simultaneously with a dislocation.
Ankle fracture requires urgent hospitalization.
In case of a fracture of the ankle joint, patients feel a sharp pain in the ankle, the leg ceases to be a support, since severe pain makes it impossible to even step on the injured leg. Only with a fracture without displacement and in the absence of dislocation can patients stand on their feet and try to move around, overcoming pain.
The diagnosis is made taking into account the patient’s complaints and X-ray examination. After that, the choice of treatment tactics is decided. The most important goal of therapy is to preserve the anatomical structure of the joint of the right or left leg.
For treatment of patients, plaster is applied, sometimes an orthopedic boot can be dispensed with, if there is no severe damage.
It is necessary to treat the fracture in full – if you do not adhere to the terms of treatment and the time of giving a full load on the leg, then later you will suffer from deforming arthrosis.
Reposition of fragments is performed both in a closed mode and during the operation. Usually, operations are performed in difficult cases when there is bone fracture or displacement. During the operation, metal structures can be supplied to strengthen the bone. The cast will take about six weeks. After the operation, rehabilitation is indicated.
Dislocation of the ankle is the most common injury to this joint. Usually, the dislocation is combined with damage to the ligaments of varying degrees.With dislocation, the bony planes are displaced relative to each other, therefore, with a sharp and strong impact, the articular capsule ruptures and the ligaments are stretched or completely ruptured.
IMPORTANT! The symptoms of dislocation are clear and obvious: immediately after an ankle injury, patients feel a sharp pain, because of this it is impossible to stand on their feet, and outwardly, an unnatural position of the leg in the ankle and protrusion from the outside of the bone can be visualized.
Why is it painful to step on the foot
Almost within a few tens of minutes, the leg swells, swells, the protruding bone is poorly visualized, since it is masked under soft tissue edema.The pain persists, its strength is individual and depends on the extent of the injuries received. When the blood vessels rupture, a hematoma appears, usually localized on the outside, closer to the bottom.
The victim in this condition must be taken to the clinic. Ice is applied to the injured limb so that the swelling does not develop even more, and the ankle itself is immobilized with improvised objects so that no further displacement occurs.
In the clinic, an X-ray is done to the victim, the degree of displacement of the articular elements is determined, and under anesthesia the bones are adjusted to the desired position.Surgical intervention is carried out in difficult cases if the injury is accompanied by a rupture of the ligaments. After all the manipulations, a plaster cast is applied for several weeks.
Deforming arthrosis can be a consequence of traumatic injury; pathology also occurs in patients of age who suffer from joint diseases – arthritis or arthrosis.
The cause of the pathology is untimely cured diseases of the joints, inflammatory changes, structural changes in the cartilage tissue, which prevent it from performing its functions normally and ensuring smooth movement of the articular surfaces.
Overweight, hormonal changes, improperly formulated diet and many other factors affect the appearance of pathology.
With the development of arthrosis, the best treatment results are obtained with early diagnosis of pathology.
Deforming arthrosis in case of untimely treatment can affect the ankle joint so badly that patients will eventually remain disabled. The first manifestations of deforming arthrosis are leg pain, redness and swelling, an increase in swelling in the leg when walking long distances.
Patients feel stiffness in the ankle joint, legs get tired quickly, especially alarming that such signs appear already in the morning, after a night’s rest.
This indicates a steadily developing pathology. If you ignore the pathology, inflammation develops.
At a doctor’s appointment, the diagnosis is confirmed by an X-ray, the stage of arthrosis in a particular patient is determined.
Treatment of deforming arthrosis is, first of all, the use of non-steroidal anti-inflammatory drugs, because the main painful symptoms are associated, first of all, with inflammation in the joint and soft tissues around it.
After the inflammation is removed, doctors switch to therapy with chondroprotectors – drugs for the regeneration of cartilage tissue.
The greatest effect from them is felt in the first two stages of the development of pathology, and symptomatic treatment is possible at the third and fourth stages.
Tendonitis also causes pain and swelling in the ankle. The pathology is associated with inflammation of the tendon that connects the calcaneus of the ankle to the muscles.
Usually pathology is a consequence of traumatic injury or can develop due to an inflammatory disease, infection.
Usually athletes suffer from tendinitis, for whom tendonitis becomes an occupational disease.
Signs of tendinitis are obvious and begin to bother the patient almost immediately after the development of the pathology. In the leg in the area of the Achilles tendon, a sharp soreness appears, the leg is painful to rotate, to pull the toe forward.In the area of inflammation, soft tissues swell, redness is observed.
IMPORTANT! When pressing on the area damaged by inflammation, a sharp pain appears, and when you try to move the joint, you can hear a crunch or click.
To diagnose pathology, it is necessary to distinguish between inflammation and signs of traumatic injury, in this case, the doctor will send the patient for an X-ray, and an ultrasound examination must also be done.
It is possible to remove inflammation with non-steroidal anti-inflammatory drugs; with the development of an infection, it is possible to prescribe antibacterial agents.
Physiotherapy procedures give a significant positive effect.
Gout is a typical disease of older patients. Pathology is associated with excessive accumulation of uric acid, which is deposited in the joints.
Aggravates the development of the disease arthritis, traumatic injuries, metabolic pathologies.
Usually, gout is most pronounced in small joints on the legs, for example, in the first toe, but if the ankle is affected, the entire foot from toes to ankle begins to suffer from manifestations of gout.
Symptoms appear long before visual signs. The patient’s leg begins to hurt, mostly pains appear at night and do not allow a person to sleep, which is why further fatigue and irritability appear. With the further development of pathology, visible signs join – the feet swell, redden and hurt.
Patients with this pathology are recommended to relieve inflammation with drugs from the NSAID group, but the treatment will not have the desired effect without correcting metabolism.
Patients are prescribed uricosuric medications that improve the metabolism of uric acid in the body. These are Allopurinol, Probenecid, Benzbromaron.
Medical baths at home, as well as physiotherapy procedures, will be useful.
Circulatory problems of the lower extremities are also a serious threat to the ankle joint. If the ankle is swollen and sore, then this may not be due to an injury or pathology of cartilage tissue, but to vascular problems.
Vascular pathologies also provoke fluid stagnation in the ankle.
Usually, swelling in the legs develops in both ankles. Pathology affects peripheral vessels, which cease to provide soft tissues with sufficient oxygen and nutrients.
The accumulation of metabolic waste and the inability of blood vessels to provide tissue trophism provokes pain and swelling, the legs may not redden outwardly, but are distributed in volume, it becomes difficult for patients to wear their usual shoes, climb stairs, and walk long distances.
In most cases, circulatory pathologies sooner or later lead to serious diseases such as varicose veins or thrombophlebitis.
If the joint is swollen from the blockage of the vessels, there is a risk of micro-necrotic areas if the adjacent vessels cannot take over the function of the affected branch.
Treatment is aimed primarily at activating blood circulation, improving tissue trophism, relieving swelling and pain.
Among other causes of edema, pregnancy and excess weight can be noted.These factors contribute to excessive stress on the ankle, as a result of which the ankle cannot cope with the load and swells.
During pregnancy, you need to be especially careful, because swelling in some women signals preeclampsia. In this case, it is necessary to consult a doctor who will prescribe medications to relieve puffiness.
In case of edema due to excess weight, correction of body weight is recommended.
Legs in the ankle can also swell due to heart and kidney diseases.These organs, first of all, affect the exchange of fluid in the body, and if the kidneys or heart do not cope with their tasks, then the water in the human body is retained, and the legs in the ankle joint begin to swell.
In this case, if the tumor appeared without injury, you need to contact a therapist who will conduct a general examination of the body and identify the causes of edema. At the first stage, symptomatic treatment is prescribed, for example, you can quickly relieve the swelling with diuretics, but in the future, treatment is aimed at the immediate cause of the onset of violations.
Diagnostics and treatment
When contacting the clinic, doctors are primarily interested in the previous trauma.
Patients with leg edema at the first visit are recommended to take an X-ray in any case, since even a minor injury can lead to a fracture in the bone or sprain.
If one lower leg is swollen, this in most cases suggests an injury; with a tumor on both legs, somatic pathologies are suspected.
An X-ray not only resolves the issue of the presence or absence of injury, but can also show the presence of bone and cartilaginous pathologies – arthritis or arthrosis of the ankle joints.
If the x-ray shows degenerative-dystrophic changes in the joint, it is necessary to additionally carry out magnetic resonance imaging, which provides comprehensive data on the condition of the damaged ankle joint.
IMPORTANT! If a ligament injury, joint capsule rupture, or concomitant soft tissue injury is suspected, ultrasound is recommended.And also, patients are prescribed a blood and urine test – these research results are especially valuable for metabolic disorders, gout, and renal failure.
After the diagnosis is made, the patient is prescribed treatment. In case of traumatic injury, the elements of the joint are corrected, which is achieved by open or closed reduction. For several weeks, you need to immobilize the joint by applying a cast or using a rigid orthosis.
In case of degenerative-dystrophic changes, the main therapy is aimed at relieving inflammation, after which drugs from the group of chondroprotectors, muscle relaxants, and means to activate blood circulation are recommended.To eliminate puffiness, phonophoresis, laser therapy, UHF, magnetotherapy are prescribed.
For prophylaxis, doctors advise wearing shoes with low heels, not putting an increased load on the legs, enriching the diet with calcium and other useful substances, treating joint pathologies in a timely manner and strengthening muscles in order to prevent hypermobility.
The ankle joint is one of the most loaded joints, due to frequent injuries, increased stress, the joint suffers from various diseases.Typical injuries of the ankle are rupture of the ligaments, dislocation and fracture, and among the non-traumatic pathologies one can note arthrosis, gout, inflammation of the ligaments, and vascular pathologies.
The symptom of all these diseases is a swelling of the foot and soreness. Manifestations on one leg in most cases indicate an injury, on both limbs – a systemic disease. To cure puffiness, it is necessary to make the correct diagnosis and undergo a course of treatment, depending on the pathology that has been identified.
The reasons why the ankle joint swells and hurts, diagnostics and methods of how to treat the disease
The ankle joint is the most vulnerable in the human body, since it is used to connect the lower leg to the foot. Thanks to him, a person can walk. And throughout its life, the joint experiences tremendous stress. But there are often times when the ankle joint swells and hurts. But before treating the pathology, you need to consider the causes of the onset of the disease.
Causes of pain
Injuries and diseases of the ankle can lead to complete immobilization of a person. Therefore, it is very important to identify the cause of the ankle swelling. Treatment must be prescribed by a doctor. In such a case, one cannot engage in self-medication, since it may even lead to disability in the future. The reasons that caused the painful condition.
Injuries of bones and ligaments
The most common joint injuries include: dislocations, ruptures or sprains of ligaments, wounds, fractures with displacement of bones, bruises.
Dislocation with sprain or ligament rupture is accompanied by pain, which intensifies when probing the surface with fingers.
Occurs with increased physical exertion, blows to the joint area or improperly selected shoes. Due to these reasons, the ankle may swell.
Sprains are often caused by twisting of the leg. There are 3 degrees of ligament damage:
- 1 degree – fiber delamination occurs.Soreness and swelling appear. The man begins to limp.
- Grade 2 – Partial rupture is characteristic. In the area of the joint, a hematoma appears, pronounced swelling of soft tissues. The victim’s movement is difficult.
- Grade 3 – complete rupture of the ligaments. It is accompanied by severe pain, edema with extensive hematoma, fever, or local hypothermia.
Symptoms of a closed fracture are not much different from dislocation. An accurate diagnosis can be made by a doctor based on X-rays.Open bone fractures are characterized by bleeding, in some cases, fragments of bone are visible.
The foot may be in the wrong position, extensive edema forms at the site of the fracture. Severe pain can cause shock.
In case of bruises, the integrity of the skin is violated, the damaged area can be very swollen, a bruise appears.
Changes in the joint with arthritis
This pathology can manifest itself at any age. The main causes of arthritis are:
- Infectious processes in the joint occur as a result of the penetration of pathogens.They can be influenza viruses, tonsillitis, furunculosis, and chlamydia.
- Joint injury after dislocation, fracture causes the development of post-traumatic arthritis.
- Failure of the immune system.
Arthritis causes severe pain in the foot or lower leg. It increases with walking or other exertion. The ankle swells, hyperemia appears, the mobility of the foot is limited. The patient has difficulty walking.
With purulent arthritis, general intoxication of the body occurs: headache, fever, chills and weakness.If the disease has become chronic, then the pain will bother you constantly. Stiffness and pain on movement appear in the morning.
Inflammation of the tissues of the ankle
The cause of swelling and swelling of the leg can be inflammation of the tissues of the joint. They occur with bursitis and synovitis. Ankle bursitis is an inflammatory process at the junction of the calcaneus with the tendon. The Achilles tendon passes close by. The reasons can be overweight, long training, flat feet, hypothermia, rheumatic diseases.Symptoms are burning pain in the joint, which increases with walking, and severe swelling appears.
And when inflammation appears in the synovial bag, which is located between the tendon and the spur on the heel, the calcaneal tubercle swells, the skin turns red, the pain intensifies, the movement is limited. If you do not pay attention to treatment, then a rupture of the heel tendon can occur.
Osteoarthritis and gout
Osteoarthritis is a disease in which not only the ankle itself is destroyed, but also the surrounding tissues: bones, cartilage and ligaments.This causes great inconvenience to a person, in addition to pain, his gait is disturbed due to deformation of the ankle. One of the reasons is the natural wear and tear of the joint.
Excess weight also affects the development of the disease. Due to the heavy load on the ankle, the tissues are destroyed. The symptom of the disease is pain, which increases with exertion, and at rest, the intensity decreases. Stiffness, swelling, redness, and impaired joint mobility may also appear.
With gout, metabolism is disturbed.The disease is accompanied by the deposition of salts in the ankle, the urate content in the blood rises. Factors favoring the development of gout are:
- Drinking alcoholic beverages.
- Diseases of the endocrine system.
- Eating foods high in purines.
- Kidney disease and taking diuretics.
- The presence of the disease in relatives.
The disease proceeds in the form of attacks, which are followed by remission. Attacks often appear at night, the leg in the ankle swells, movement is sharply limited, and an increasing, unbearable pain appears. The joint cannot be touched.
Tendinitis and plantar fasciitis
A pathology in which the Achilles tendon becomes inflamed, is called tendinitis . Mostly people of the older generation get sick with it. But it can also manifest itself in young people who are intensely involved in sports.
The causes of the disease are: mechanical injuries, inflammatory processes, heavy physical exertion, infections, metabolic disorders, rheumatic diseases. Hypothermia, allergic reactions and congenital abnormalities also contribute to the development of tendonitis. The main symptom is ankle pain.
There is redness and swelling, a crunch in the tendons, painful sensations on palpation of the heel and foot.
Plantar fasciitis is popularly called the “heel spur”.With this pathology, the fascia-ligament becomes inflamed, which connects the calcaneus and the metatarsal, and passes along the inner side of the fossa of the foot. The reasons are: excess weight, wearing uncomfortable and tight shoes, flat feet, osteochondrosis of the lumbar spine, inflammatory diseases, impaired blood supply.
This pathology includes thrombosis and thrombophlebitis . With thrombosis, clogging of the veins by a thrombus occurs. It interferes with good blood flow and this leads to the accumulation of excess fluid in the limbs.There is swelling and pain in the lower leg area. At the initial stage, the swelling is invisible, but after a while the swelling increases.
Thrombophlebitis – inflammation of the vein wall caused by a blood clot. The disease begins acutely, accompanied by swelling, pain, general weakness and fever. Blood clots are caused by: vascular disease, overweight, tumor processes, hormonal factors, trauma, paresis. Also, the reasons may be: obesity, drinking alcohol, a sedentary lifestyle, very heavy loads.
Another reason may be varicose veins. With varicose veins, the veins of the lower extremities lose their elasticity and are damaged under blood pressure. There is swelling below the knee, the skin becomes dry and shiny, becomes bluish in color.
If the leg is swollen in the ankle area, you need to pay attention to the heart, kidneys, liver and lungs. Diseases of these organs can lead to the accumulation of fluid in the lower extremities and be manifested by the formation of edema.
Edema may appear due to vasoconstriction, increased permeability.The appearance of edema is not always associated with the disease.
They can be caused by excessive fluid intake, excessively salty food, pregnancy, when the load on the joints increases.
It is imperative to contact a medical facility if ankle swelling appears. The reasons and treatment should be prescribed by the doctor, after the diagnosis.
Methods of diagnosis and treatment
There are many modern diagnostic methods for making a correct diagnosis of .They allow the doctor to prescribe the treatment that is right for that particular patient.
The patient must undergo a thorough examination, which includes: a study of blood and urine, X-ray of the joint, ultrasound of the ankle and MRI. And only on the basis of the results, the doctor will select an effective medication treatment, prescribe physiotherapy.
Drugs of different groups are used for drug treatment.
- Diuretics increase the amount of fluid excreted from the human body.The amount of urine and the rate of its formation increase, as a result of which the fluid content in the tissues and cavities decreases.
- Nonsteroidal anti-inflammatory drugs reduce joint inflammation, relieve pain, lower body temperature and quickly restore motor function. These drugs relieve the symptoms of the disease and only partially affect the cause. Therefore, they are prescribed in combination with other drugs.
- Chondroprotectors prevent the destruction of cartilage, relieve inflammation, stimulate the formation of cartilage components and promote the production of intra-articular fluid.
- Local anesthetic ointments, gels and creams can reduce swelling and partially relieve pain. No side effects, available without a prescription, but check with your doctor before buying.