The so-called snowboarder’s ankle is a bone fracture of the ankle bone. This injury is particularly common in snowboarders.
What is a snowboarder’s ankle?
A snowboarder ‘s ankle is understood to be a fracture of the talus. This leads to a fracture of the lateral process of the foot, an extension of the ankle bone. Since snowboarding became popular as a winter sport, the incidence of this injury has increased significantly. For epidemic keratoconjunctivitis explanations, please visit aviationopedia.com.
Fractures of the lateral process of the tali have been known since the mid-1960s. However, at that time there was no connection to snowboarding. Scientific research only took place when snowboarding injuries increased. When it was clear that it was a fracture that is typical for this sport, it was initially given the name snowboarder’s fracture.
Later, the term “snowboarder’s ankle” became influential. The English word “ankle” includes the ankle bone. Basically, the talus fracture is one of the rarer injuries. Their share is often less than five percent. Sometimes an ankle bone fracture can also occur with other injuries to the foot, such as fractures of the heel bone or ankle.
A fracture of the ankle bone or a snowboarder’s ankle is caused by massive impact of violence. This can also occur outside of snowboarding as a result of falls from a great height or traffic accidents. In snowboarding, the fracture usually occurs after the athlete lands on an uneven surface. The type of snowboard boot also seems to play an important role in the injury.
However, there are still different theses about the probability. Advanced athletes are usually particularly affected by a snowboarder’s ankle, because beginners usually do not jump with the board. The mechanism of the snowboarder’s ankle is based on a mixture of axial compression and dorsiflexion. Movements such as pronation, supination and external rotation also play a role.
Another sport in which ankle bone fractures are common is water wakeboarding. This involves the performer strapping a board around their feet, which is pulled by a motorboat, allowing the athlete to glide on the water. It is also not uncommon for a talus fracture to be recorded in rear-end collisions where the driver extends his leg to brake his vehicle.
Symptoms, Ailments & Signs
A typical symptom of a snowboarder’s ankle is severe pain in the ankle area. Furthermore, there is a pronounced swelling in connection with a bruise (hematoma). In addition, there is limited mobility in the ankle joints. The injured person can no longer walk.
Possible accompanying injuries are impairments of the inner and outer ankles, a fracture of the heel bone or lower leg, metatarsal fractures or open wounds. The fracture lines can vary in a talus fracture. The size of the fracture fragments is usually different. Medicine differentiates between several fracture types.
Type I is a fracture in which the talus is not dislocated relative to adjacent structures. In Type II there is a dislocation towards the lower ankle, while in Type III there is a dislocation within the upper and lower ankle. In type IV, the status is similar to type III. However, there is also displacement of the talonavicular joint.
Diagnosis & course of disease
When diagnosing the snowboarder’s ankle, there is a risk that the injury will be mistaken for a ruptured ligament, strain or sprain on the lateral malleolus. This risk is considered to be particularly high when the attending physician is not aware that the patient is a snowboarder. For this reason, the preparation of the medical history is very important.
In addition, the fracture of the bone cannot always be clearly identified on the X-ray images. Computed tomography (CT) is then considered helpful because it shows the fracture lines without superimposition. This also helps the doctor plan the appropriate treatment. Magnetic resonance imaging (MRI) can be used to detect necrosis.
The course of the snowboarder’s ankle depends on its severity. With grades III and IV, there is a risk that osteoarthritis will develop over time. Complications such as avascular necrosis of the ankle bone are also a threat.
Patients with a snowboarder’s ankle can usually only move to a limited extent. Due to the pain and bruising, walking is only possible with severe discomfort or – in the case of a serious injury – not at all. Larger hematomas run the risk of blood getting into the joint and causing inflammation.
Accompanying the snowboarder’s ankle, impairments of the inner and outer ankle as well as fractures of the heel bone and lower leg usually also occur. Open wounds can become infected and lead to further complications. Depending on the severity of the fracture, other symptoms such as osteoarthritis or avascular necrosis of the ankle bone may develop over time.
Osteoarthritis leads to instability of the joint over the years and can thus lead to permanent changes in the movement and chronic pain. As a result of avascular necrosis, signs of paralysis can occur or the affected joint may even have to be amputated. The surgical treatment of the snowboarder’s ankle involves the typical risks: bleeding, infections, nerve injuries and wound healing disorders. Occasionally, allergic reactions to the materials used can also occur.
When should you go to the doctor?
The snowboarder’s ankle used to be a rather rare phenomenon. Today, this fracture of the ankle bone occurs much more frequently. If a snowboarder’s ankle is suspected, a doctor’s visit is essential for the snowboarder. Wakeboarders or athletes who perform similar movement patterns are also susceptible to this particular fracture. It usually occurs when landing after a daring jump that only experienced snowboarders can do.
Anyone who notices pain and swelling in and on their feet after a jump should take this seriously. It may be a snowboarder’s ankle, although the symptoms are more likely to look like a strain, sprain, or torn ligament. A medical examination is therefore necessary. The doctor should be informed that the damage occurred while snowboarding. The fracture is not always visible on the x-ray. Computed tomography is probably necessary in order to be able to carry out the subsequent treatment properly.
The attending physician has several options. Depending on whether it is a small or medium-sized broken bone fragment or a comminuted fracture, surgery may or may not be required. Conservative cast immobilization is rarely carried out. It only affects patients who are considered to be at risk for surgery. Osteoarthritis can occur later as a result of immobilization. Surgical treatment is therefore usually necessary.
Treatment & Therapy
The type of treatment performed depends on the type of talus fracture. If the outer fragment is large enough, surgical refixation can be performed using mini-fragment screws. Refixation is considered to be more advantageous for the patient than conservative therapy.
If refixation cannot be performed, there is the option of removing small fragments or debris. As part of a conservative therapy, the foot is immobilized in a plaster cast, with a equinus position taking place at the same time. However, the risk of complications with conservative treatment is considered to be higher than with surgery.
For this reason, it is usually only used in patients who have contraindications to surgical intervention. Conservative treatment is also possible for an uncomplicated Type I snowboarder’s ankle. The duration of treatment is around eight weeks.
A snowboarder’s ankle can only be effectively prevented if you don’t snowboard, which very few people want to do. In general, however, very risky situations can be avoided. Regular training of reflexes and coordination is also helpful.
If the snowboarder’s ankle was treated surgically, follow-up care takes place. After the operation, the patient is given a plaster splint, which he wears until the swelling has subsided. In addition, the surgical wound must have healed before the splint can be removed.
Physiotherapy is an important part of the follow-up treatment. One of their goals is to maintain foot mobility. Muscle training is also important. In the beginning, however, only partial loads are carried out.
The patient must rest his operated limb consistently for at least six weeks. Depending on how the healing process goes, rest can take up to 12 weeks. The patient is therefore forced to resort to crutches during this period. However, the physiotherapy exercises are useful because they improve the mobility of the upper and lower ankle joint after the talus fracture.
If the ankle bone is no longer in contact with the upper and lower ankle as a result of the injury, it must be relocated as quickly as possible. This procedure can be used to counteract avascular bone necrosis, in which the bone dies due to blood flow. After setting in, early passive mobilization is also important.
Follow-up care also includes radiological check-ups, which serve to check the healing process. In addition, possible complications can be detected and treated at an early stage.
You can do that yourself
In the event of a fracture of the talus, a doctor must always be consulted as soon as possible. This is especially true when pain occurs after a risky jump and a hard landing on uneven ground. A talus fracture is often mistaken for a sprain and the affected person only treats it with cold compresses or other home remedies. If it breaks, however, this can lead to serious complications, which is why a doctor must always be consulted. Since a fracture of the talus is not always immediately recognizable even for medical professionals, the treating doctor must be informed that the injury occurred while snowboarding. This is the only way to ensure that the appropriate diagnostic measures are initiated.
Whether special physiotherapy is required after the fracture has healed depends on the severity of the injury and the duration of the convalescence. If the foot is not allowed to bear any weight for longer than six weeks, the probability increases that not only muscles but also cartilage mass will be reduced. In addition, the basic motor characteristics can also be impaired. In this case, the patient must exercise patience and slowly restore the functionality of the affected foot with the help of targeted physiotherapy exercises.
A snowboarder’s ankle can only be prevented by renouncing the sport or at least by renouncing dangerous jumps.