Ankle Fracture

Ankle Fracture

An ankle fracture usually occurs as a result of accidents during sports or leisure activities. This type of injury often occurs while jumping or running. The ankle is often twisted or twisted.

What is an ankle fracture?

An ankle fracture is a fracture of the ankle crotch at the upper ankle on the lower leg. A fibula fracture is the most common. In an ankle fracture, there can be different combinations of injuries to the lateral or medial malleolus and ligaments. For comprehensive guide to chronic venous insufficiency, please visit growtheology.com.

Ankle fractures are divided into three categories. A Weber A fracture is present when the fracture is below the syndesmosis. The syndesmosis is a flat connective tissue that connects the joint bones together and thus stabilizes the joint. With a Weber’s A fracture, the syndesmosis is not injured, so the ankle yoke remains stable.

A Weber B fracture is at the level of the syndesmosis. As a result, they are often injured as well. In a Weber C fracture, the point of fracture is above the syndesmosis, which is usually torn. In addition to these main types of ankle fracture, there can be various other forms, which differ in the different location of the bone fracture and the injuries to the surrounding tissue or ligaments. Before treatment, an accurate diagnosis of the ankle fracture is always required.

Causes

In almost all cases, an ankle fracture can be traced back to an accident. Most accidents happen during sports or other leisure time activities. In some cases, alcohol is also a causal factor in the occurrence of the accident. An ankle fracture can occur from twisting the ankle. Most often this is caused by slipping or stumbling.

A so-called twisting fall can also lead to an ankle fracture. A twisting fall is a common skiing accident. In addition, ankle fractures can also result from traffic accidents or exposure to direct force on the ankle. Rarely are coordination disorders or a disturbed perception of one’s own body movements the cause of an ankle fracture.

Symptoms, Ailments & Signs

An ankle fracture is primarily manifested by severe, mostly acute pain in the area of ​​the affected joint. Externally, the fracture can be recognized by the swelling in the joint area. Depending on the severity of the injury, bleeding and skin damage can also occur in varying degrees of severity. The load-bearing capacity of the injured joint is usually greatly reduced immediately after the fracture.

In addition, there are occasional sensory disturbances and nerve pain. The most obvious feature is the stabbing pain that occurs when the affected foot is stepped on. The pain sets in immediately after the injury and persists for several days to weeks. As the fracture heals, so does the pain.

Swelling and other accompanying symptoms disappear completely after just a few days. The reduced exercise capacity can sometimes persist for a few weeks or even months, depending on the severity of the fracture and the therapeutic measures taken. With extensive physical therapy, an ankle fracture can heal in four to six weeks.

Competitive athletes often need several months to fully compensate for the muscle wasting that occurs during the rest phase. Externally, this deficiency can be seen in the apparently emaciated calf and foot muscles.

Diagnosis & History

When diagnosing an ankle fracture, an examination of the mobility, sensitivity and blood circulation of the foot and lower leg is essential. In addition to the suspected fracture, injuries to the syndesmosis or the surrounding ligaments and soft tissue can also be determined.

Possible damage to nerves or vessels is also diagnosed in this way. An X-ray examination is carried out to examine the fracture in detail. X-rays show fracture lines and joint irregularities. Magnetic resonance imaging or computed tomography can be used to finally clarify suspected ligament tears or injuries to the syndesmosis during the physical examination.

With professional treatment, ankle fractures usually heal well and without complications. In most cases, the ankle is completely healed and resilient again after the treatment has been completed. Physiotherapy following medical therapy is important.

Usually, most sports are possible again six to twelve weeks after the cast no longer has to be worn. Complications are rare in ankle fractures that require surgery. Wound healing disorders also occur only rarely. In rare cases, wound healing disorders can occur after an ankle fracture with severe soft tissue damage.

Complications

A fracture of the ankle can cause various complications. These include, for example, pressure necrosis of the skin, which is due to the thin skin conditions, the misalignment of the bones and the development of swelling. In some cases, the surgical removal of a metal implant may be necessary. Dislocation fractures are considered to be particularly problematic.

The skin in the area of ​​the inner ankle is often under great tension, so that a quick, rough dislocation has to be carried out. If the ankle is loaded too early after the fracture, there is a risk that the osteosynthesis material will shift or even break off. As a result, the fracture does not heal or pseudarthrosis (wrong joint formation) occurs.

Older people who suffer from osteoporosis (bone loss) are often affected by this complication. For this reason, patients usually receive special orthotic shoes. Other conceivable consequences of an ankle fracture include restricted movement, chronic pain, reduced strength, stiffening of the ankle, the development of arthrosis, damage to the nerves such as sensory or movement disorders, circulatory disorders due to vascular injuries and impairments to the tendon.

In addition, complications can occur during the surgical therapy of the ankle fracture. These are mostly thromboses (blood clots), embolisms, injuries to vessels or nerves as well as wound or joint infections, which are caused by permanent movement restrictions. If there is a severe soft tissue injury in addition to the ankle fracture, there is a risk that the wound healing will be delayed.

When should you go to the doctor?

If an ankle fracture is suspected, surgery is required in most cases. After that, the foot must not be loaded for weeks. Going to the doctor is inevitable. It must be done immediately after the ankle fracture has occurred. In most cases, those affected know there is a fracture. The foot often twists after the fracture and causes considerable pain. It can swell considerably.

When someone falls or slips, the sudden load often causes a twisting fracture of the ankle. It is one of the most common broken bones in the leg. Skiers are affected just as often as other athletes who do a lot of footwork. Since the ankle area with the adjacent foot is essential for walking and standing, it is important to treat this fracture as quickly as possible.

In the case of open fractures, emergency treatment must begin immediately. The emergency doctor takes care of the initial treatment before transport to the hospital. Closed torsional fractures often involve multiple broken bones. Here, too, the ambulance must be called. Rarely, a simple and inconspicuous ankle fracture occurs. It is only noticeable through swelling. Here, too, you should go to the doctor promptly so that there is no consequential damage to ligaments or tendons.

Treatment & Therapy

The first treatment of an ankle fracture should take place at the scene of the accident if possible. The foot should be brought back into its normal position by a longitudinal pull. This prevents further damage to nerves and vessels. Further treatment depends on the type of fracture. Conservative treatment can be given. This is non-surgical therapy.

A plaster cast is applied. This will immobilize the fracture site and allow it to heal in peace. Medication to prevent thrombosis is usually necessary while the plaster cast has to be worn. After the treatment with a plaster cast and sometimes even during it, another X-ray examination is necessary to check the bone positions and the healing success.

Conservative therapy is mostly used for Weber type A ankle fractures. Surgical treatment is required for complicated or open fractures. The broken ends of the bones are fixed with nails, plates or wires. In the case of Weber-A and Weber-B ankle fractures, partial weight bearing is possible after the operation and a plaster cast is applied for further treatment.

In the case of Weber C-type fractures, it is usually necessary to completely relieve the affected leg for several weeks. This means that in this case the patients have to stay in bed for several weeks so that the ankle fracture can heal in peace.

Prevention

An ankle fracture can only be prevented to a limited extent, because the fracture usually occurs as a result of an accident. It is at best possible to avoid particularly high-risk sports or at least to take precautionary measures as far as possible. In some cases, joint protectors and appropriate footwear can prevent an ankle fracture.

If the ankle fracture is operated on, follow-up treatment follows. Once the soft tissues have gone down, mobilization can begin. Depending on the extent of the symptoms, crutches can be used just one or two days after the surgical procedure, provided the supply is stable. If, on the other hand, the supply is unstable, only partial loading is possible. Depending on the quality of the bone, a lower leg cast or an orthosis can be used.

Aftercare

One of the most important follow-up measures for an ankle fracture is mobilizing and putting pressure on the pain-free body region. The load is either full or as a partial load of up to 15 kilograms. Normally, a full load can take place after four to six weeks. The foot can already bear weight in the first few days after the operation, provided that this does not lead to pain. After three to six months, the patient can normally go back to sporting activities.

Sometimes the metal implants that were used to surgically treat the foot also have to be removed. The screws and plates can sometimes have a negative effect due to the thin layer of skin and fat tissue. However, if there is no pain from the implants, there is no need to remove them.

If the patient wears a plaster splint, it is important to position it in an elevated position. To prevent thrombosis from forming, the patient receives appropriate medication in the form of ready-to-use injections. These are injected once a day.

You can do that yourself

In everyday life, care must be taken to ensure that the bone structure is not exposed to excessive stress or situations of excessive demands. Movement sequences must therefore be optimized and timely breaks taken as soon as existing energy reserves are depleted. Wearing suitable and healthy footwear should take place. High heels should be avoided and the shoe size should correspond to the size of the feet. Otherwise, there may be an increased risk of accidents or complications in a healing process.

In the case of an ankle fracture, it is particularly important to relieve the affected physical region during the healing process. Motion sequences are to be reduced to a minimum. Immobilization of the injured joint is often necessary.

As soon as the situation improves, a slow build-up of muscles and loads is necessary. Daily exercises support the organism in improving health. Normally, a cooperation with a physiotherapist takes place. He develops exercises according to the individual needs of the patient. The training units can also be carried out independently outside of the meetings. Nevertheless, close coordination with the therapist is advisable so that complications or excessive stress can be prevented. When performing sporting activities, protective means such as bandages are needed to stabilize the joint, to use. In the case of particularly severe complaints, these can also be used in everyday life when moving around.

Ankle Fracture