Ankle Fracture Management

ankle bandageAn ankle fracture is a break in the bones that make up the ankle joint. The ankle is formed by three bones, the tibia known as shin bone, fibula-smaller bone of the lower leg and the talus, a small bone wedged between the heel bone (calcaneus) and tibia and fibula. Fractures can occur at medial malleolus –between tibia and tallus on the medial part (inner side of the foot), lateral malleolus- between fibula and tallus on the lateral part (outer side of the foot), and posterior malleolus- posterior part of tibia (back of the foot). Fractures are diagnosed with the help of an X-ray.

Any kind of fracture gives rise to symptoms such as swelling, severe pain, tenderness and restriction of movement. An important step in treatment of an ankle fracture is to minimize the swelling which in turn will help control pain. Basic treatment includes application of ice to reduce swelling and rest. Leg elevation helps reduce the swelling. Painkillers such as NSAIDs are used for temporary relief of pain. Compression with the help of a crepe bandage will help give support and reduce swelling. Immobilization is a must. Usually, a splint will be applied to allow the ankle joint to rest. If the fractured bones are not displaced, the splint may be put on without moving the broken ankle. If any bone is displaced from its normal position, a procedure called as a ‘reduction’ will be performed to reposition the bone. Use of crutches is advised for a few weeks for maximum rest and quick recovery.

Treatment of an ankle fracture depends on the stability of the joint. Generally an unstable joint, bimalleolar, and trimalleolar fractures require surgery. If the joint is unstable, mobility is impaired; chances of developing early arthritic changes are high. Surgery is advisable to prevent such complications. In some injuries, there is communication between the skin and the fracture. This is known as an ‘open fracture’ or ‘compound fracture’. There are high chances of infection in such fractures necessitating immediate surgery. Often, procedures called ‘open reductions’ and ‘internal fixations’ are performed where permanent metallic implants hold the bones in place while the natural healing process occurs. A cast or splint for immobilization for a few weeks should not be avoided even after surgery.

Whether you have a serious or minor ankle fracture, feel free to contact us for professional assistance.

Penned by Dr. Rachita Narsaria, MD

References:

  1. http://orthoinfo.aaos.org/topic.cfm?topic=A00391
  2. http://www.webmd.com/fitness-exercise/ankle-fracture
  3. http://www.stopsportsinjuries.org/overuse-injury.aspx
  4. Harrison’s Textbook of Internal Medicine. 18th ed.