What are the symptoms of a broken ankle. How can you prevent ankle fractures. What causes broken ankles and who is at risk. What complications can arise from a broken ankle. How is a broken ankle diagnosed and treated.

Understanding Broken Ankles: An Overview

A broken ankle, also known as an ankle fracture, is a common injury that occurs when one or more bones in the ankle joint break. The ankle joint consists of three main bones: the tibia (shinbone), fibula (smaller bone of the lower leg), and talus (a bone that sits between the heel bone and the tibia and fibula). When excessive force is applied to the ankle, these bones can crack or break completely.

Ankle fractures can range from minor hairline cracks to severe breaks that pierce the skin. The severity of the fracture determines the treatment approach and recovery time. Understanding the symptoms, causes, and prevention methods of broken ankles is crucial for proper care and management of this injury.

Recognizing the Symptoms of a Broken Ankle

Identifying the signs of a broken ankle is essential for seeking timely medical attention. Common symptoms include:

• Immediate, throbbing pain
• Swelling around the ankle area
• Bruising and discoloration
• Tenderness when touched
• Visible deformity or misalignment
• Difficulty or pain when walking or bearing weight

Can you walk on a broken ankle? While it may be possible to walk on a broken ankle in some cases, it is not recommended. Attempting to walk or put weight on a potentially broken ankle can worsen the injury and lead to complications.

When to Seek Medical Attention

It’s important to consult a doctor if you experience any of the following:

• Obvious deformity of the ankle
• Persistent pain and swelling that doesn’t improve with self-care
• Worsening pain or swelling over time
• Inability to walk or bear weight on the affected ankle

Common Causes of Broken Ankles

Broken ankles can result from various incidents and activities. Understanding the common causes can help in prevention and risk assessment. The most frequent causes include:

1. Twisting injuries: Sudden rotational forces applied to the ankle during falls or missteps
2. Direct trauma: Impact from car accidents or falling objects
3. Sports injuries: High-impact activities or sudden changes in direction
4. Falls: Especially from heights or on uneven surfaces
5. Missteps: Simply putting your foot down wrong can sometimes lead to a fracture

How do most ankle fractures occur? The majority of ankle fractures happen due to twisting injuries, where the foot is planted and the body rotates around it, applying excessive force to the ankle bones.

Risk Factors for Ankle Fractures

Certain factors can increase an individual’s likelihood of experiencing a broken ankle. These risk factors include:

• Participation in high-impact sports (e.g., basketball, football, gymnastics)
• Use of improper sports equipment or techniques
• Sudden increase in physical activity levels
• Living in a cluttered or poorly lit environment
• Underlying medical conditions like osteoporosis
• Smoking, which can affect bone density and healing

Are some people more prone to ankle fractures? Yes, individuals with weakened bones, those participating in high-risk activities, and people with certain medical conditions may be more susceptible to ankle fractures.

Potential Complications of Broken Ankles

While complications from broken ankles are relatively uncommon, they can occur and may include:

• Arthritis: Fractures extending into the joint can lead to arthritis years later
• Osteomyelitis: Bone infection, particularly in open fractures
• Compartment syndrome: A rare condition causing pain, swelling, and potential disability in leg muscles
• Nerve or blood vessel damage: Trauma to the ankle can injure nearby nerves and blood vessels

Does a broken ankle always lead to arthritis? No, not all broken ankles result in arthritis. However, fractures that affect the joint surface have a higher risk of developing post-traumatic arthritis over time.

Diagnosis and Treatment Options for Broken Ankles

Proper diagnosis and treatment are crucial for optimal recovery from a broken ankle. The diagnostic process typically involves:

1. Physical examination
2. X-rays to determine the location and severity of the fracture
3. CT scans or MRI for more detailed imaging in complex cases

Treatment options vary depending on the severity and location of the fracture:

• Conservative treatment: Rest, ice, compression, and elevation (RICE) for minor fractures
• Immobilization: Casting or splinting to allow proper healing
• Surgery: Required for severe fractures, involving the use of plates, rods, or screws to maintain proper bone alignment
• Physical therapy: To restore strength and mobility after the initial healing period

How long does it take for a broken ankle to heal? The healing time for a broken ankle can vary widely, typically ranging from 6 to 12 weeks. However, complete recovery and return to full activities may take several months, depending on the severity of the fracture and individual factors.

Prevention Strategies for Ankle Fractures

While not all ankle fractures can be prevented, several measures can reduce the risk:

• Wear appropriate footwear for different activities and terrains
• Replace athletic shoes regularly to ensure proper support
• Start new fitness programs gradually and warm up before exercising
• Cross-train to prevent overuse injuries
• Maintain a diet rich in calcium and vitamin D for bone health
• Keep living spaces clutter-free and well-lit to prevent falls
• Strengthen ankle muscles through targeted exercises

Can ankle-strengthening exercises prevent fractures? While strengthening exercises can improve ankle stability and reduce the risk of sprains, they may not directly prevent fractures caused by high-impact trauma. However, stronger muscles can provide better support to the ankle joint overall.

Living with a Broken Ankle: Recovery and Rehabilitation

Recovering from a broken ankle requires patience and adherence to medical advice. The rehabilitation process typically involves:

1. Initial rest and immobilization phase
2. Gradual weight-bearing as advised by the doctor
3. Physical therapy to regain strength and range of motion
4. Slow return to normal activities under medical supervision

During recovery, it’s essential to:

• Follow the doctor’s instructions carefully
• Attend all follow-up appointments
• Perform prescribed exercises consistently
• Use assistive devices (crutches, canes) as recommended
• Be patient and avoid rushing the healing process

Will a broken ankle fully recover? In most cases, with proper treatment and rehabilitation, a broken ankle can heal completely. However, the recovery time and extent may vary depending on the severity of the fracture and individual factors.

Long-Term Outlook and Considerations

After recovering from a broken ankle, it’s important to:

• Continue with ankle-strengthening exercises
• Be mindful of uneven surfaces and potential hazards
• Wear supportive footwear
• Listen to your body and avoid overexertion
• Maintain overall bone health through diet and exercise

Can you prevent future ankle fractures after having one? While having a previous ankle fracture doesn’t necessarily increase the risk of future fractures, it’s important to take preventive measures and be cautious to avoid similar injuries in the future.

Understanding the Impact of Broken Ankles on Daily Life

A broken ankle can significantly affect various aspects of daily life, including:

• Mobility and independence
• Work and professional responsibilities
• Participation in sports and recreational activities
• Mental health and emotional well-being

Coping strategies for managing life with a broken ankle include:

1. Adapting your living space for easier navigation
2. Seeking support from family and friends
3. Exploring work-from-home options or modified duties if applicable
4. Engaging in upper body exercises to maintain overall fitness
5. Practicing stress-reduction techniques to manage frustration and anxiety

How can you stay active with a broken ankle? While traditional exercises may be limited, you can focus on upper body workouts, core strengthening, and non-weight bearing activities as approved by your doctor. Swimming or water exercises may also be recommended once the cast is removed and the wound has healed.

Emotional and Psychological Aspects of Recovery

Recovering from a broken ankle isn’t just a physical process; it can also take an emotional toll. It’s important to:

• Acknowledge feelings of frustration or depression
• Seek support from loved ones or professional counselors if needed
• Set realistic recovery goals and celebrate small victories
• Stay connected with friends and maintain social interactions
• Explore new hobbies or interests that don’t require ankle mobility

Can a broken ankle affect your mental health? Yes, the limitations and challenges associated with a broken ankle can impact mental health. It’s important to address both physical and emotional aspects during the recovery process.

Advances in Broken Ankle Treatment and Research

Medical advancements continue to improve the treatment and outcomes for broken ankles. Some recent developments include:

• Minimally invasive surgical techniques
• Advanced imaging technologies for more precise diagnosis
• Improved materials for casts and braces
• Innovative rehabilitation techniques, including virtual reality-based therapies
• Biological treatments to enhance bone healing

Ongoing research focuses on:

1. Developing new materials for internal fixation devices
2. Exploring stem cell therapies to accelerate bone healing
3. Improving pain management techniques
4. Enhancing rehabilitation protocols for faster recovery

How might future treatments improve recovery from broken ankles? Future treatments may lead to faster healing times, reduced complications, and more personalized approaches to rehabilitation, ultimately improving patient outcomes and quality of life during recovery.

The Role of Technology in Ankle Fracture Management

Technology is playing an increasingly important role in the management of broken ankles:

• 3D printing for custom-made casts and orthotics
• Wearable devices to monitor healing progress
• Telemedicine for remote follow-up appointments
• Mobile apps for guided at-home rehabilitation exercises
• Virtual reality systems for balance and proprioception training

Can technology improve the healing process for broken ankles? While technology cannot replace the natural healing process, it can enhance monitoring, improve patient compliance with treatment plans, and provide more engaging rehabilitation experiences, potentially leading to better outcomes.

Special Considerations for Different Age Groups

The approach to treating and managing broken ankles can vary depending on the patient’s age:

Children and Adolescents

Considerations for younger patients include:

• Growth plate involvement and potential long-term effects
• Faster healing rates compared to adults
• Need for age-appropriate rehabilitation strategies
• Importance of proper nutrition for bone development

Adults

For adult patients, key factors include:

• Impact on work and daily responsibilities
• Potential for complications related to pre-existing conditions
• Longer recovery times compared to children
• Importance of maintaining overall fitness during recovery

Older Adults

Elderly patients may require special attention to:

• Increased risk of complications due to reduced bone density
• Potential impact on overall mobility and independence
• Need for fall prevention strategies during and after recovery
• Consideration of pre-existing health conditions in treatment planning

Do broken ankles heal differently in various age groups? Yes, the healing process can vary significantly between age groups. Children typically heal faster due to their active growth plates, while older adults may experience slower healing and a higher risk of complications.

The Economic Impact of Broken Ankles

Broken ankles can have significant economic implications, both for individuals and healthcare systems:

• Direct medical costs for treatment and rehabilitation
• Indirect costs due to lost productivity and time off work
• Potential long-term costs for ongoing care or management of complications
• Impact on healthcare resource utilization

Strategies to mitigate the economic impact include:

1. Preventive measures to reduce the incidence of ankle fractures
2. Efficient diagnostic and treatment protocols to minimize healthcare costs
3. Effective rehabilitation programs to facilitate faster return to work
4. Education and awareness programs to promote ankle health and safety

How can the economic burden of broken ankles be reduced? Implementing comprehensive prevention programs, optimizing treatment pathways, and improving rehabilitation strategies can help reduce the overall economic impact of broken ankles on individuals and healthcare systems.

Insurance Considerations for Broken Ankle Treatment

Understanding insurance coverage is crucial for managing the costs associated with broken ankle treatment:

• Review your health insurance policy for coverage details
• Understand potential out-of-pocket expenses
• Explore options for supplemental coverage if needed
• Consider the impact on disability insurance if applicable
• Be aware of coverage limits for physical therapy and rehabilitation services

Does insurance typically cover all costs related to a broken ankle? While many health insurance plans cover a significant portion of broken ankle treatment costs, patients may still be responsible for deductibles, copayments, or costs for services not covered by their plan. It’s important to review your specific policy and discuss financial concerns with your healthcare provider.

Broken ankle – Symptoms & causes

Overview

A broken or fractured ankle is an injury to the bone. You may experience a broken ankle from a twisting injury from a simple misstep or fall, or from direct trauma during a car crash, for example.

Foot and ankle bones

A fall or blow to your ankle can break one or more of the three bones in your ankle joint the fibula, the tibia and the talus. Rolling your ankle can cause a break in the knobby bumps at the end of the tibia and fibula.

The seriousness of a broken ankle varies. Fractures can range from tiny cracks in your bones to breaks that pierce your skin.

Treatment for a broken ankle depends on the exact site and severity of the bone fracture. A severely broken ankle may require surgery to implant plates, rods or screws into the broken bone to maintain proper position during healing.

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Symptoms

If you have a broken ankle, you may experience some of the following signs and symptoms:

• Immediate, throbbing pain
• Swelling
• Bruising
• Tenderness
• Deformity
• Difficulty or pain with walking or bearing weight

When to see a doctor

See a doctor if there is obvious deformity, if the pain and swelling don’t get better with self-care, or if the pain and swelling get worse over time. Also, see a doctor if the injury interferes with walking.

Causes

A broken ankle is usually a result of a twisting injury, but can also be caused by a direct blow to the ankle.

The most common causes of a broken ankle include:

• Car accidents. The crushing injuries common in car accidents may cause breaks that require surgical repair.
• Falls. Tripping and falling can break bones in your ankles, as can landing on your feet after jumping down from just a slight height.
• Missteps. Sometimes just putting your foot down wrong can result in a twisting injury that can cause a broken bone.

Risk factors

You may be at higher risk of a broken ankle if you:

• Participate in high-impact sports. The stresses, direct blows and twisting injuries that occur in sports such as basketball, football, gymnastics, tennis and soccer can cause ankle fractures.
• Use improper technique or sports equipment. Faulty equipment, such as shoes that are too worn or not properly fitted, can contribute to stress fractures and falls. Improper training techniques, such as not warming up and stretching, also can cause ankle injuries.
• Suddenly increase your activity level. Whether you’re a trained athlete or someone who’s just started exercising, suddenly boosting the frequency or duration of your exercise sessions can increase your risk of a stress fracture.
• Keep your home cluttered or poorly lit. Walking around in a house with too much clutter or too little light may lead to falls and ankle injuries.
• Have certain conditions. Having decreased bone density (osteoporosis) can put you at risk of injuries to your ankle bones.
• Smoking. Cigarette smoking can increase your risk of developing osteoporosis. Studies also show that healing after a fracture may take longer in people who smoke.

Complications

Complications of a broken ankle are uncommon but may include:

• Arthritis. Fractures that extend into the joint can cause arthritis years later. If your ankle starts to hurt long after a break, see your doctor for an evaluation.
• Bone infection (osteomyelitis). If you have an open fracture, meaning one end of the bone protrudes through the skin, your bone may be exposed to bacteria that cause infection.
• Compartment syndrome. This condition can rarely occur with ankle fractures. It causes pain, swelling and sometimes disability in affected muscles of the legs.
• Nerve or blood vessel damage. Trauma to the ankle can injure nerves and blood vessels, sometimes actually tearing them. Seek immediate attention if you notice any numbness or circulation problems. Lack of blood flow can cause a bone to die and collapse.

Prevention

These basic sports and safety tips may help prevent a broken ankle:

• Wear proper shoes. Use hiking shoes on rough terrain. Choose appropriate athletic shoes for your sport.
• Replace athletic shoes regularly. Discard sneakers as soon as the tread or heel wears out or if the shoes are wearing unevenly. If you’re a runner, replace your sneakers every 300 to 400 miles.
• Start slowly. That applies to a new fitness program and each individual workout.
• Cross-train. Alternating activities can prevent stress fractures. Rotate running with swimming or biking.
• Build bone strength. Get enough calcium and vitamin D. Calcium-rich foods include milk, yogurt and cheese. Ask your doctor if you need to take vitamin D supplements.
• Declutter your house. Keeping clutter off the floor can help you to avoid trips and falls.
• Strengthen your ankle muscles. If you are prone to twisting your ankle, ask your doctor for exercises to help strengthen the supporting muscles of your ankle.

Broken Ankle or a Sprain: How do you Know?

February 8, 2018

You fall and injure your ankle. Next you gauge your pain and ask: “Is it a broken ankle or a sprain?” This scenario accounts for one of the most common complaints; yet a simple twist and fall could become a complex injury involving bone, cartilage, ligaments and tendons. In this blog I will discuss ankle fractures and what the next steps are on the road to recovery.

Ankle Anatomy

Three bones make up the ankle: the tibia, the fibula, and the talus. The tibia and fibula are commonly involved in a broken ankle (ankle fracture). These articulate in multiple directions to account for the ankle’s complex range of motion. Motion between bones occurs against smooth surfaces covered with cartilage. Cartilage allows for fluid motion at a joint due to its low level of friction. For those familiar with carpentry, you can think of these bones as a mortise and tenon joint where the talus bone acts as the tenon (tongue) attached to the foot and the tibia and fibular act as the mortise making up the lower leg.

These bones are secured by ligaments (deltoid, syndesmosis, lateral ligament complex) that maintain this relationship. The deltoid ligament originates from the medial malleolus (medial tibia) and inserts on the talus, calcaneus and navicular bones of the foot distally. While commonly injured, surgical repair of this ligament is often unnecessary. The lateral ligament complex includes the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). The most common type of ankle sprain involves the ATFL. The third major ligament complex is called the syndesmosis. This connects between the fibula and tibia throughout the lower leg. Injuries to this ligament are often referred to as a “high ankle sprain” and develop with rotation.

Pain free motion of the ankle relies heavily on this complex congruent relationship between the talus and the tibia and fibula. If the ankle joint is even displaced 1mm, a 42% increase in pressure to ankle may occur¹. A change in the bony anatomy of the ankle involved with an ankle fracture may introduce enough change in alignment that the ankle is now at risk for future arthritis.

Is the Ankle Sprained or Broken?

A thorough evaluation by an Orthopedic Specialist in Foot and Ankle such as Dr. Miller will identify the nature of the injury. Immediately following the injury, it is reasonable to assess the ankle with weight bearing. If there is no pain with walking, an ankle fracture is highly unlikely. Soreness with walking but the ability to walk normally suggests a contusion or sprain of the ankle. However, if you cannot stand on the ankle, an evaluation is warranted to rule out a broken ankle or ankle fracture.

Swelling is another sign of injury. If the swelling comes on gradually and is mild, the injury is likely a sprain or less severe. More immediate and significant swelling indicates a bony injury and possible fracture. When severe fractures occur, blistering of the skin is not uncommon. The blisters emanate from excessive swelling in the soft tissues following a severe fracture. Sometimes the ankle is dislocated with this amount of swelling. Immediate medical attention is required in these circumstances to reduce the ankle. Once severe swelling or blistering sets in, this can take weeks until the initial swelling resolves. In many cases these changes can delay surgery on the ankle.

As time passes ecchymosis (bruising) may occur. This can be extensive; however, this does not necessarily mean the ankle is broken. More severe ankle sprains present with significant ecchymosis over the region of injury. Besides not being able to put pressure down on the ankle or a deformity in the ankle after injury, a good reason to be evaluated for a broken ankle/ankle fracture is continued symptoms that worsen or stay the same. Some ankle fractures are stable enough that you may still be able to walk. Some people have a high pain tolerance that allows them to cope with the injury. These scenarios are best evaluated by an orthopedic surgeon when not improving.

Orthopedic Evaluation

Once you have made the decision to be evaluated for ankle pain, Dr. Miller will assess you and your injury as a whole. This includes a detailed history and physical examination with special focus on the ankle. Your age, mobility level and medical history are important, particularly as it relates to the ability heal an injury or recover from a potential surgery. Preexisting medical conditions such as diabetes, vascular problems, and inflammatory disease (e.g. rheumatoid) must be accounted for during the planning of treatment. Any remote history related to the ankle or previous injury should be known.

Physical examination will be performed during your visit. It is important to assess the ankle based on its appearance including deformity, any open wounds around the ankle, the amount of swelling present, and any preexisting rashes or skin issues. Vascular exam is used to determine the appropriate blood flow to the lower extremity, and this is performed by checking the dorsalis pedis and posterior tibialis pulses surrounding the foot and ankle. A neurological exam of the lower extremity will be used to assess any nerve injuries and the ability to move the foot. The extremity will then be evaluated for areas of tenderness and pain. This will help to locate the injury in a broken ankle more specifically and rule out other concurrent pathology.

Findings from the physical exam will then be used to evaluate radiographs of the affected ankle and surrounding areas. X-rays consist of three views of the ankle and any other areas of concern. While minimizing radiation is a good general rule, lower extremity x-rays use very low levels of radiation and in comparison account for a small fraction of the radiation you naturally receive yearly by living on Earth². Based on these images, Dr. Miller can evaluate for the presence of a fracture and the severity of the fracture.

Treatment

Once you have been identified to have a broken ankle/ankle fracture, how will the ankle be treated? Assuming you have an ankle fracture, the most important decision is whether the fracture can be treated non-surgically or the broken ankle  requires surgical intervention. This decision would be made by Dr. Miller taking into account all variables described above.

In many cases the decision to perform surgery depends on the stability of the ankle. If 2 or more different fractures are identified in the ankle, surgery is commonly warranted due to the concern for instability and movement of the pieces. If the pieces heal non-anatomically, the ankle may be predisposed to accelerated wear and arthritis. If only one fracture is identified, the decision to perform surgery relies on the location and character of the fracture. Further radiographs that stress the ankle may be warranted to make this determination.

If the broken ankle has been considered stable enough to not require surgery, early weight bearing in a protective boot may be an option. This type of protection can be required for 6 weeks. You would wear the boot during all weight bearing activities. Usually at 6 weeks there is adequate healing to start weaning out of the boot.

If the broken ankle/ankle fracture is severe or unstable, surgical intervention utilizing metal implants is likely required. The day of surgery a patient typically will receive a nerve block prior to surgery that helps with anesthesia and pain control after the procedure. This process anesthetizes the leg to achieve temporary numbness. Once this is complete the actual surgery usually lasts between 1 and 2 hours. The surgery consists of reducing the broken pieces of the ankle to where they were prior to the injury and maintaining that reduction with metal hardware. Generally one or two incisions are used. A soft cast or splint would be applied for temporary protection until you return the office. After surgery it is imperative to elevate your leg to your heart level consistently until seen in the office. This improves pain relief and wound healing.

When you return to the office, the ankle is usually ready to be placed in a boot for protection. For the next 5-6 weeks no weight is to be put on the leg in most cases. One can start showering 2 weeks after the surgery on average. Around 6 weeks after the surgery, you can progressively apply weight to the leg while in the boot until you are completely weight bearing in the boot without an assist device. Range of motion and therapy begins 4-6 weeks after surgery. You can drive 9 weeks after surgery if your right leg was injured. Eleven to 12 weeks after surgery the boot is replaced with a shoe and possibly an ankle brace. Return to full impact and running would be achieved in the following months.

Appointments can be made with Dr. Adam G. Miller by calling (513)-354-3700 or booking online here.

¹ Ramsey PL, Hamilton W. Changes in tibiotalar area of contact caused by lateral talar shift. J Bone Joint Surg Am. 1976 Apr;58(3):356-7. Epub 1976/04/01.
² Coughlin MJ, Saltzman CL, Mann RA. Mann’s Surgery of the Foot and Ankle: Expert Consult-Online and Print: Elsevier Health Sciences; 2014.

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Ankle fracture – how it happens, classification, treatment methods

The information provided on the page should not be used for self-treatment or self-diagnosis. If you suspect a disease, you should seek help from a qualified specialist. Only your doctor can diagnose and prescribe treatment.

Contents of the article:

• How fracture occurs
• Ankle fracture classification
• Symptoms
• Diagnostics
• First aid
• Treatment and clinical guidelines
• Surgical treatment
• Possible complications

What is an ankle fracture?

An ankle fracture is a partial or complete fracture of the leg bones. Ankle fractures can range in severity from less severe injuries involving small pieces of bone near the joint to severe fractures of the tibia and fibula, or both. Ankle fractures are common injuries, most often caused by the ankle twisting inward or outward. Many people mistake an ankle fracture for an ankle sprain, but the consequences are completely different and therefore require accurate and early diagnosis. Treatment and rehabilitation at home depends on this. Fortunately, both surgical and non-surgical treatments are being used today. All ankle fracture injuries should be evaluated by a physician to determine severity.

How a fracture occurs

Ankle fractures, more commonly known as ankle fractures, occur when one or more of the bones that make up the ankle joint is broken. Although an ankle fracture is an injury seen at almost any age, it is more common among older people and athletes who are physically active.

When the bones are damaged, the ankle becomes unstable. With the addition of ligament injuries, the injury can become a very serious problem, complications after an ankle fracture are possible.

An ankle fracture can be caused by sudden, inadvertent movement, such as twisting the ankle during sports or activity. Car accidents can also cause ankle fractures, especially after heavy impacts.

Also, a person can trip, fall, twist the ankle – this can cause an ankle fracture. Depending on age and previous health conditions, this problem can develop into much more serious damage if left untreated. Source:
Ankle injury analysis. Tailashev M.M., Salatin P.P., Sobolev V.V., Pozikov V.V., Kolesnikov A.S. Acta Biomedica Scientifica, 2008. p. 144-145.

Classification of ankle fractures

The ankle joint itself is formed by three bones – this is the largest tibia, then the fibula (shin bone) and the talus. It is located in the area between the calcaneus, as well as the greater and fibular bones. Ankle fractures are classified according to the area of ​​the broken bone:

• fracture in the area of ​​the medial malleolus is the inner surface of the tibia;
• posterior malleolus injury is the dorsum of the tibia;
• lateral malleolus fracture is an injury to the edge of the fibula.

The stability of the ankle joint is determined by the strength of the ligaments and bones. In case of fractures in the area of ​​the ankle joint, two joints are affected:

• ankle joint – formed by the lower leg, talus, fibula;
• joint syndesmosis is the area between the tibia and fibula held together by ligaments Source:
  Ankle joint fractures and treatments. Cherednik A.A., More Gautam Saherbao, Al-Fakih Abdulaziz. Bulletin of Medical Internet Conferences, 2014. p.432.

Symptoms

Since a sprain can sometimes feel like a broken ankle, it is always important to consult a doctor. Assessing the symptoms of an ankle fracture and post-injury pain helps in determining how serious the injury is.

An ankle fracture is accompanied by one or all of the following symptoms:

• pain at the fracture site, which in some cases may radiate from the foot to the knee;
• Significant swelling that may occur along the length of the leg or be more localized. How long the swelling lasts will depend on the severity of the injury and the amount of damaged tissue;
• a bruise that appears shortly after the injury;
• inability to walk, stepping on the whole leg. Therefore, the doctor will tell you how to walk correctly after an injury. However, a person can walk with less severe fractures, so never rely on walking as a test to see if a bone has been broken;
• changed the appearance of the ankle – it will be different from the other ankle;
• bone protrudes from under the skin in an open fracture. Fractures penetrating the skin require immediate intervention as they can lead to severe infection and prolonged recovery.

Diagnosis

The doctor will discuss with the patient the medical history (how long it hurts, before the injury) and symptoms. He will also ask how the injury happened and examine the affected area. If the traumatologist believes that you may have broken your ankle, they will order a series of examinations to more fully study the injury.

X-ray : X-rays can show if the ankle bone has been broken and how many fragments of the broken bone are there. They can also determine if there is a dislocation (tear between broken bones). The doctor may also take x-rays of other parts of the leg or foot to make sure nothing was damaged as a result of the injury.

Stress Test : A stress test is performed to determine if surgical procedures are needed to heal an injury. The doctor will put some pressure on the ankle and take a special x-ray to determine the severity of the lesion.

CT Scan (Computed Tomography): If the fracture extends beyond the ankle joint, a CT scan may be required to further investigate the injury. CT scanning allows you to get an image of a series of images in different planes, by which the doctor can determine the severity of the injury. Source:
Comprehensive diagnosis of ankle injuries. Kim L.I., Dyachkova G.V. Genius of Orthopedics, 2013. pp. 20-24.

MRI scan (Magnetic Resonance Imaging): If the doctor suspects a ligament injury has occurred, they may order an MRI scan to better view the affected area. MRI can look deeper into bones and soft tissues, such as ligaments, to create higher resolution images than most other tests.

Ankle fracture first aid

Ankle fracture treatment depends on the type and severity of the injury. First aid is needed to prevent further damage from a broken ankle and shorten the time for bone healing.

• Rest : relieve the injured ankle. Walking can lead to further injury, and only a doctor can determine when to step on your foot.
• Ice : apply an ice pack to the injured area by placing a thin towel between the ice and the skin. You need to use ice for 20 minutes and then wait at least 40 minutes before doing a cold compress again.
• Compression : An elastic bandage should be used to control swelling.
• Height : Ankle should be slightly elevated above heart level to reduce swelling.

Ankle fracture: treatment, clinical guidelines

If the traumatologist determines that the patient has a broken ankle, it is necessary to determine what type of fracture it is and how to treat it. Ankle fractures can be treated with non-surgical methods, as long as the injury is not too severe or unstable.

• Lateral fibula fracture . If the ankle is stable, non-surgical healing methods are available. These can range from wearing tall tennis shoes to short casts. The doctor may recommend rest and crutches to keep the foot light and to make sure that the fragments do not move during healing.
• Fracture of the tibia on the inside of the lower leg . If the fracture is all in place or if it is very minor, it can be cured if the ankle is not stressed for 6 weeks. A short leg bandage or a removable bandage, as well as a doctor’s recommendation when it is possible to walk, usually speeds up the healing process.
• Fracture of the back of the leg at the level of the ankle joint . In most cases, the fibula also breaks due to the fact that it shares ligaments with the posterior malleolus. If the ankle remains stable, it can be treated without surgery. Treatment may include a short leg bandage or a removable brace. It is important to determine the severity so that arthritis does not develop. As you heal, you will need to gradually develop an ankle fracture.
• Bimalleolar equivalent fracture (two of the three parts of the ankle broken) indicates that the ligaments on the inside of the ankle are also damaged. Because these injuries are usually unstable, surgery is usually recommended. In case of health problems that may interfere with the operation, a splint and a short bandage on the leg may be applied. You will need to see your doctor regularly to make sure your ankle remains stable.
• Trimalleolar fracture (all three parts of the ankle are broken). Since this is a very difficult situation, surgery is almost always recommended. Rare non-surgical treatment options include a short leg bandage, a splint, and regular doctor visits.

If the joint located between the tibia and fibula is damaged, and the ligaments are also affected, the damage can heal like an ankle sprain. The injury can be treated by removing weight from it without surgery.

However, in most cases sprains and one or more fractures occur. Recovery after an ankle fracture is rarely without surgical treatment. Source:
Treatment tactics for intra-articular fractures of the ankle joint (literature review). Zedgenidze I.V., Tishkov N.V. Acta Biomedica Scientifica, 2013. pp. 178-182.

Surgery

In the event that non-surgical treatments do not work or the ankle is too unstable, your doctor may recommend surgery for a broken ankle, followed by rehabilitation. After the operation, it is important to walk the leg, perform all the prescribed procedures in order to shorten the rehabilitation period.

Features of the operation: if the fragments are not in place, the bone fragments must be moved surgically. The fragments had to be returned to their normal position and fastened with special screws and metal plates attached to the outer surface of the bone. The surgery may involve bone grafting so that the new bone can actively heal. It is fixed with screws and a metal plate. This may reduce the risk of arthritis and speed up the return of movement.

Possible complications

After treatment, it is important to follow the surgeon’s instructions. Failure to follow this rule can lead to infection, deformity, arthritis, and chronic pain. Source:
Errors and complications in the treatment of complex ankle fractures. Salikhov R.Z., Pankov I.O., Plakseichuk Yu.A., Solovyov V.V. Practical medicine, 2014. p. 128-131.

• Mistakes and complications in the treatment of complex fractures of the ankle joint. Salikhov R.Z., Pankov I.O., Plakseichuk Yu. A., Solovyov V.V. Practical medicine, 2014. p. 128-131
• Ankle injury analysis. Tailashev M.M., Salatin P.P., Sobolev V.V., Pozikov V.V., Kolesnikov A.S. Acta Biomedica Scientifica, 2008. p. 144-145
• Comprehensive diagnosis of ankle joint injuries. Kim L.I., Dyachkova G.V. Genius of Orthopedics, 2013. p.20-24
• Fractures of the ankle joint and methods of treatment. Cherednik A.A., More Gautam Saherbao, Al-Fakih Abdulaziz. Bulletin of Medical Internet Conferences, 2014. p.432
• Therapeutic tactics for intra-articular fractures of the ankle joint (literature review). Zedgenidze I.V., Tishkov N.V. Acta Biomedica Scientifica, 2013. p.178-182

symptoms, treatment, prevention at home

Each ankle consists of an outer – lateral, and an inner – medial malleolus, these are different parts of the fibula and tibia. From the outside, we see them as two tubercles on the inside and outside of the ankle joint.

Both ankles form a “fork” of the ankle joint, through which the person’s weight is transferred to the foot. A fracture is a violation of the integrity of the bone, it can affect different anatomical structures. It is possible to fracture only the inner, only the outer ankle, or both.

If the bones are displaced or shattered, this fracture is considered complicated. Additionally, the subluxation of the joint aggravates the situation. Sometimes fragments break through the skin and tissues – then the fracture becomes open.

Symptoms of an ankle fracture

An ankle fracture can be suspected after the very fact of the injury: they fell awkwardly, twisted their leg, jumped from a height. At the time of the fracture, a crackling sound can sometimes be heard. The limb is deformed, arched at an unusual angle.

This is followed by pain, usually in the ankle area, but not always. The joint is limited in mobility, it is impossible to step on the foot. Gradually, the joint swells, a bruise grows and redness appears.

Ankle fracture treatment

If the bones are not displaced and there are no other complications, bone fragments, ligament rupture, it is usually sufficient to apply a cast for 4 to 8 weeks. With such an uncomplicated fracture, it is possible to immobilize the leg with the help of modern orthoses and bandages. They are made of durable plastic or metal covered with fabric and secured with Velcro. The bandage can be adjusted to the size of the leg, if necessary, remove and wipe the skin, but this cannot be done without the permission of the doctor.

If the fracture is closed, but there is a displacement, before applying a bandage, a reposition is performed – reduction of the joint. This is done in a hospital under local anesthesia. After that, plaster is also applied.

Surgery is necessary if bone displacement cannot be corrected without surgery, or if there is subluxation or other complications. Surgery is considered very effective, after which the ankles heal faster and complications are rare. The operation is usually performed a few days after the injury.

Regardless of the way in which the bones are placed in the correct position, rest must be observed. You can’t step on your foot, you have to walk with the help of crutches.

Diagnostics

Ankle fractures must be distinguished from ligament injuries. For an accurate diagnosis, an x-ray of the ankle joint is performed. In the picture, the traumatologist sees exactly how the fragments have shifted, what is the severity of the injury.

X-ray shows mostly hard tissues, it is difficult to assess the condition of soft tissues. In doubtful cases, computed tomography and MRI are additionally prescribed.

Modern methods of treatment

After fixing the ankle joint in the correct position, it takes a long time for all damaged tissues to recover. Physiotherapy can speed up the healing process. It improves blood circulation, facilitates the outflow of lymph and relieves swelling.

The doctor prescribes the type of therapy depending on the severity of the injury. This can be warming up with the help of paraffin applications, infrared laser therapy. Often prescribed electrophoresis with calcium to accelerate the healing of bones, magnetotherapy, acupuncture.

Ankle fracture prevention at home

Active young people and athletes, as well as the elderly, are most susceptible to this injury. The love of stilettos also increases the risk of ankle fracture, in such shoes the foot is unstable and often tucked.

Lack of exercise increases the likelihood of injury. At the same time, the muscles weaken, all the pressure falls on the bone tissue, which may not withstand the load. In older patients, the risk of injury also increases. This is due to the frequent development of osteoporosis, in which the bones become thinner and brittle.

To reduce the risk of an ankle fracture, you need to give yourself feasible physical activity, avoid uncomfortable shoes, monitor calcium levels and bone density.

Popular Questions and Answers

This injury is one of the most common. An ankle fracture accounts for up to 20% of all skeletal injuries. Traumatologist-orthopedist Sergey Prokofiev answered popular questions from patients.

How to provide first aid for a fracture?

The main thing is not to try to stand on the injured leg. You need to sit down and use gentle pressure to feel the lower leg to determine exactly where it hurts. Next, you need to fix the ankle joint with anything, at least two boards on both sides, and wrap it with a bandage or cloth on top. If this is not done, the bone fragments may be displaced.

You need to call an ambulance or take the victim to the emergency room. While waiting for transport, apply cold to the site of pain from two opposite sides. Suitable, for example, bottles of cold water or frozen foods.

If high-top shoes are worn, no attempt should be made to remove them. Just loosen the laces or unzip. Only if the shoes squeeze the ankle joint, you can try to pull it off a little, but it’s better not to. The limb should be elevated to reduce swelling. You can take any painkillers.

What are the possible complications of a fracture?

Unfortunately, it is not always possible to completely restore a joint. Complications develop in 10% of patients. This usually occurs with a complicated fracture of the ankle with displacement or subluxation.

In case of incorrect reduction, damage to blood vessels and nerves during trauma, pain or loss of sensation in the ankle joint is possible even after healing. And if the bones did not grow together correctly and the operation was not performed, a shortening of one of the bones, lameness, may develop.

How long does it take to recover from a fracture?

It will take 4 to 8 weeks to wear a cast or orthosis, sometimes more. During this time, physiotherapy, control x-rays are done. X-rays determine whether there is a repeated displacement of the bones, and then how well the bones have grown together. After that, the plaster is removed.