Ankle Fracture and Ankle Sprain

Broken Ankle treatments and recovery

The ankle joints are one of the most important joints of our body as they play an essential role in our mobility. One misstep and your ankle is gone for good. These joints take a hefty amount of the stress and pressure of our daily movements and perform a fairly good job to support our body weight.

Ankle Fracture

Any trauma at the ankle joint can result in an ankle fracture. This means that the bones making up this joint are broken. Such fractures commonly occur at the leg bones i.e., tibia or fibula, and are usually due to an extreme twisting of the ankle joint. Following are the most common causes of this type of fracture:

1.    Impact or shock from a vicious fall

2.    Trauma to the ankle due to a car accident

3.    Rolling the ankle in or out

4.    Extreme flexion or extension at the joint

5.    Poor bone health and diet i.e., a diet lacking calcium and vitamin D.

Broken ankles affect people of all ages and occupations. But most commonly, it is found among physically active people and athletes who participate in high impact sports like sprinting, tennis, football, basketball, and soccer. The symptoms of a fractured ankle include the following:

1.    Pain and swelling at the ankle or along the leg

2.    Tenderness at the affected joint

3.    Difficulty in walking or putting weight on the foot

4.    Failure to move the ankle

5.    Apparent deformity of joint

6.    Bruising of the fractured area

7.    The pointy end of the fractured bone may pierce the skin and become exposed to the outside

8.    Numbness of the foot

Treatment

1.    In-home therapy

The fractured joint should be immobilized at all costs and ice packs should be applied to minimize the swelling and to prevent any further deterioration of the condition. Keeping the ankle elevated also helps minimize the pain and swelling. Over-the-counter painkillers can be used if accessible which allows reduction of the agony and discomfort of the individual. The next step should include the prompt transfer of the patient to a clinic or a hospital setting where a further evaluation of the situation can determine the necessary course of action.

2.    Non-surgical treatment (when fractured bones are in place)

Upon examination, if the consultant tells you that the bones are not that far out of place, he may proceed to suggest you settle this problem with an ankle brace or support. It is like a short leg cast which minimizes the movement of the fractured joint. Some physicians let the patients put weight on their leg right away while others ask them to take necessary precautions for at least six weeks. Regular follow-up visits and X-ray studies of the affected joint characterize the prognosis of the healing process.

3.    Surgical treatment (when fractured bones are out of place)

If the fracture is out of place or the ankle is unstable then the fracture has to be fixed by surgical intervention. During this type of procedure, the bone fragments are first reduced into their normal position and are then held together with the help of wires, screws, or metallic plates. In some cases, a rod may be placed inside the bone to keep the fragments intact as they heal.

Ankle Sprain

An ankle sprain is due to damage to the tough ligaments that surround the ankle joint. The injury usually happens when you accidentally awkwardly twist your foot. This can stretch and tear the ligaments, or may even avulse them in grave situations. The purpose of the ligaments is to keep the ankle stable by restricting the over-expansive movement at the joint. A sprain prevents you from taking proper steps while walking. Following are a few symptoms involved in this condition:

1.    Ankle stiffness

2.    Pain and discomfort

3.    Inability to put weight on the affected joint

Grades of Ankle Sprain

After a thorough examination, the physician will analyze the best course of treatment according to the degree of severity. Ankle sprains are graded based on how much damage has been incurred by the ligaments.

Grade 1 sprain (mild): The ankle is mildly swollen and has very little tenderness. There is slight stretching and/or microscopic tears in the ligaments.

Grade 2 sprain (moderate): There is partial tearing of the ligaments. The tenderness and swelling are only moderate but reduce the extent of ankle mobility.

Grade 3 sprain (severe): There is a complete tear or avulsion of any of the ligaments supporting the ankle. The pain is significant and is sometimes even unbearable for the patients.

Treatment

1.    First aid

The first and foremost action that the patient can take himself is applying ice packs to the affected area. Refrain from excessive movement to prevent further damage. Putting on elastic bands or wrapping the area with clothing straps can put pressure on the site and help mitigate the throbbing pain. Crutches can be used if available to prevent excessive weight burden over the damaged joint. Elevation of the affected ankle is also needed to prevent high perfusion of the swollen area and in turn reduction of the inflammation. After the settlement of the initial pain, it is necessary to pay the physician a visit to prevent any further complications.

2.    Non-Surgical Treatments of the Sprain

More than 90% of patients with ankle sprain do not require any surgical intervention and can be easily rehabilitated by using simple steps. In addition to the first aid remedies described above, some extra precautions must be taken for a complete recovery. Most commonly, the physician will advise using an ankle splint. This helps keep the joint in place and prevents excessive mobilization. Also, temporary ankle braces or pneumatic medical boots can serve the same purpose as well.

The pneumatic medical air boots look like ski boots that have an inflatable inner lining for additional application of compression. Normally, the brace or splint is used for at least 6 weeks. Along with this, the patient is also advised to use crutches which enable him to walk without putting extra weight on the healing joint.

3.    Surgical Treatment

Surgical treatment for ankle sprains is very rarely utilized and is only selected for those injuries which fail to heal using non-surgical methods. There are two different ways to treat the sprain surgically.

Arthroscopy. In this technique, the doctor inserts a small camera which shows the whole view inside the joint cavity. This is called an arthroscope. Then, minor instruments are introduced to remove any broken fragments or parts of the ligament. Minor stitches can also be applied during this technique to ensure maximum chances of healing.

Reconstruction. The doctor may open the joint surgically and repair the torn or damaged ligaments with stitches and sutures. In some situations, a graft must be used from other places of the body to repair the damage.

Rehabilitation/Recovery from Surgery. The time of rehabilitation may take from weeks to months. The length usually depends upon the extent of the injury and the nature of surgical repair required. Proper diet and care can significantly extend the recovery time of the patient.

How to prevent ankle sprains and fractures?

1.    Wear proper shoes. Use appropriate shoes for the specific sport and replace them regularly after they wear out.

2.    Maintaining a good diet rich in proteins, calcium, and vitamin D.

3.    Regular exercises for strengthening the muscles around the ankle to provide better stability.

4.    Proper warm-up before every exercise can significantly reduce the chances of an ankle fracture.

5.    Avoiding the use of high heels for female patients. Rather wear comfortable shoes or sneakers fitting the natural contour of the feet.

6.    Avoid smoking as it delays bone healing and bone remodeling.