Ankle fracture

Description

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

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

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

Symptoms

If you have an ankle fracture, you may experience some of the following signs and symptoms:

  • Immediately, throbbing pain
  • Swelling
  • Bruising
  • Tenderness
  • Deformity
  • Difficulty or pain when you walk or bear weight

When to see a doctor

See a doctor if there is obvious deformity, if the pain and swelling do not improve with self-care, or if the pain or swelling gets worse with time. Also, see a doctor if the injury interferes with the activity of walking.

Causes

An ankle fracture 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 an ankle fracture are:

  • Car accidents. The crushing of the common injuries in car accidents may cause jumps that require surgical repair.
  • Falls. Slips and falls can break the bones of the ankles, as you can land on your feet after jumping down from a small height.
  • Missteps. Sometimes you just put your foot on the ground wrong can result in a twisting injury that can cause a bone fracture.

Risk factors

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

  • Participate in high-impact sports. The stress, direct blows, and twisting injuries that occur in sports such as basketball, football, gymnastics, tennis and football can cause fractures of the ankle.
  • The inappropriate use of technology or sports team. Faulty equipment, such as shoes that are too worn or not adjusted properly, can contribute to stress fractures and falls. Improper training techniques, such as not warming up and stretching, may also cause ankle injuries.
  • Suddenly increase their activity level. Whether you're an athlete trained or someone who is just starting the exercise, of a sudden, increase the frequency or the duration of the exercise sessions can increase your risk of a stress fracture.
  • Keep your home cluttered or poorly lit. Walking in a house with a lot of clutter or too little light can cause falls and injuries in the ankle.
  • You have certain conditions. Decreased bone density (osteoporosis) can put you at risk of injuries to the bones of the ankle.
  • The habit of smoking. Cigarette smoking can increase your risk of developing osteoporosis. The studies also show that healing after a fracture may take longer in people who smoke.

Complications

Complications of ankle fracture are rare, but may include:

  • Arthritis. Fractures that extend into the joint can cause arthritis years later. If your ankle starts to hurt a lot after a break, see your doctor for an evaluation.
  • Bone infection (osteomyelitis). If you have an open fracture, which means one of the ends of the bone that protrudes through the skin, the bone may be exposed to the bacteria that cause the infection.
  • The compartment syndrome. This condition can rarely occur with ankle fractures. It causes pain, swelling and sometimes disability in the muscles of the legs.
  • The nerves or the blood vessels. Trauma to the ankle can damage nerves and blood vessels, sometimes you have to really break them. Seek immediate medical attention if you notice any numbness or circulatory problems. The lack of blood flow can cause a bone to die and collapse.

Prevention

These basic sports and safety tips can help prevent an ankle fracture:

  • Wear proper shoes. The use of hiking shoes on the rough terrain. Choose the sports shoes for your sport.
  • Replace your sports shoes regularly. Dispose of the sneakers as soon as the tread or in the heel wears down or if the shoes wear out unevenly. If you are a runner, replace your running shoes every 300 to 400 miles.
  • Start slowly. That applies to a new fitness program and each of the exercises.
  • Cross-train. The alternation of activities that can prevent stress fractures. Rotate running, swimming or cycling.
  • Build the strength of the bones. Get enough calcium and vitamin D. foods rich in Calcium are milk, yogurt and cheese. Ask your doctor if you need to take supplements of vitamin D.
  • Declutter your home. Keeping the clutter on the floor can help to prevent trips and falls.
  • Strengthen the ankle muscles. If you are prone to twisting your ankle, ask your doctor for exercises to help strengthen the muscles that support your ankle.

Ankle fracture

Diagnosis

Your doctor will examine your ankle to check for points of tenderness. The exact location of your pain can help determine its cause.

Your doctor can move your foot into different positions to test his range of motion. You may be required to walk a short distance, so that your doctor can examine your gait.

Tests

If signs and symptoms that suggest a break or fracture, the doctor may suggest one or more of the following imaging tests.

  • The x-ray. The majority of ankle fractures can be visualized on x-rays. The technician may need to take X-rays from different angles to the bone images do not overlap too much. Stress fractures often do not appear on X-rays until the break actually starts the healing.
  • Bone scan. A bone scan can help your doctor diagnose fractures that do not appear on x-rays. A technician will inject a small amount of radioactive material into a vein. The radioactive material is attracted to the bones, especially the parts of the bones that have been damaged. The damaged areas, including stress fractures, show up as bright spots in the resulting image.
  • The computed tomography (CT). computed tomography (CT) takes X-rays from different angles and combines them to make cross-sectional images of the internal structures of your body. The ct scan can reveal more details about the injured bone and the soft tissues that surround it. A ct scan can help your doctor determine the best treatment for his broken ankle.
  • Magnetic resonance imaging (MRI). Magnetic resonance imaging (MRI) uses radio waves and a strong magnetic field to create very detailed images of the ligaments that help hold your ankle together. This image helps to show the ligaments and the bones and can identify fractures that are not seen on x-rays.

Treatment

Treatments for a broken ankle will vary, depending on which bone is broken and the severity of the injury.

Drugs

Your doctor may recommend an over-the-counter pain relievers, such as acetaminophen (Tylenol, others).

Therapy

After your bone has healed, you will probably have to loosen stiffness of the muscles and ligaments of the feet and ankles. A physical therapist can teach you exercises to improve the flexibility, balance and strength.

Surgical or other procedures

  • Reduction. If you have a displaced fracture, which means that the two ends of the fracture are not well aligned, your doctor may need to manipulate the pieces back into their correct position. This process is called reduction. Depending on the amount of pain and swelling, you may need a muscle relaxant, a sedative and a local anesthetic to numb the area prior to this procedure.
  • The immobilization. A broken bone must be immobilized so that it can heal. In most cases, this requires a special boot or a cast.
  • Surgery. In some cases, an orthopaedic surgeon may require the use of pins, plates, or screws to maintain the correct position of the bones during healing. These materials can be removed after the fracture has healed if they are important or painful.

Preparing for your appointment

It is likely that initially seek treatment for an ankle fracture in an emergency room or urgent care clinic. If the pieces of broken bone are not aligned properly for healing, you may be referred to a doctor specializing in orthopedic surgery.

What you can do

You can write a list that includes:

  • Detailed descriptions of its symptoms
  • The information about the medical problems that you have had
  • Information about the health problems of your parents or siblings
  • All of the medications and supplements you take
  • Questions you want to ask the doctor

For an ankle fracture, 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 much time do I need to use it?
  • I'm going to need surgery?
  • What activity restrictions you need to follow?
  • You should see a specialist?
  • What pain medications you recommend?

Don't hesitate to ask any questions you may have.

What to expect from your doctor

Your doctor may ask some of the following questions:

  • There was a specific injury that triggers your symptoms?
  • Did your symptoms appear suddenly?
  • Have injured their ankles in the past?
  • It has started recently, or the intensification of an exercise program?

What to do in the meantime

If your injury is not serious enough to justify a trip to the emergency room, here are some things that you can do at home to take care of your injury until you can see your doctor:

  • Apply ice for 15 to 20 minutes at a time, every three to four hours to keep the swelling down.
  • Keep the ankle elevated.
  • Do not put any weight on the injured ankle.
  • Lightly wrap the injury in a soft bandage that provides light compression.
Symptoms and treatment of ankle fracture