A fracture around the ankle joint is a common injury. It is especially important to treat these fractures properly since our feet and ankles are necessary for walking and weight bearing.
The foot itself contains 26 bones and the ankle joint actually involves three bones. A broken ankle can involve one or more bones, as well as injuring the surrounding connecting tissues such as ligaments and capsule.
Mechanism and Symptoms
Fractures around the ankle can occur as a result of a fall, twisting injury, a motor vehicle accident or some other trauma to the ankle. Because a severe sprain can often mask the symptoms of a broken ankle, every injury to the ankle should be examined by a physician.
Symptoms of a broken ankle include:
- Immediate and severe pain
- Tender to the touch
- Inability to put any weight on the injured foot
- Deformity, particularly if there is a dislocation of the joint as well as a fracture
- X-rays help in identifying the exact location of the fracture. In children an x-ray of the opposite normal ankle may be asked for a comparison to see subtle changes in growth plates due to injury.
- Sometimes a CT (computed tomography) scan or a bone scan will also be needed to better understand the anatomy of the injury to plan for further treatment
Ankle fractures may be treated non-operatively using a splint device to restrict movement of the fracture area, the use of pain killers to subdue the pain, or a rest and limb elevation which allows you lie down on a bed with a sling rest lifting the leg in a position above the heart. A cast may be used for definitive treatment when fractures are relatively undisplaced for about 4-6 weeks depending on the severity of the fracture.
Surgery may be indicated for most ankle fractures particularly if they are displaced. The goal is always to achieve anatomical reduction which means the optimal reformation of the fracture bones to maintain alignment of the broken bones. The surgeon may use a plate, metal or absorbable screws or wires to hold the bones in place.
After surgery, patients will be placed into a splint to rest the ankle and allow the tissues to settle down and to aid in healing. Patients will be provided with crutches and taught how to walk without putting any weight on your operated ankle (non-weight bearing). Patients will be put into physiotherapy later on to rehabilitate the ankle joint and strengthen it. This improves range of motion of the joint.
Recovery time varies depending upon the type of fracture or need for surgery. The average fracture requires 6-8 weeks for the bone to heal, after which weight bearing may be allowed in a gradual manner. Sometimes fractures may need a longer time to heal and may require secondary surgical procedures particularly if the bones fail to heal or to remove the metal-work.
Fractures of any type increase the likelihood of developing arthritis in the affected joint. The more severe the fracture, the higher the risk of developing some degree of arthritis.