Understanding Ankle Fractures to Get the Right Treatment
The ankle is a joint of the body where three bones meet at the foot. The talus is the bone below the ankle joint. The tibia is the larger shin bone, and the fibula is the smaller outside bone of the leg. The ankle is a weight-bearing joint, and the tibia alone is responsible for carrying 90 percent of the weight-bearing pressure while walking.
In an ankle fracture, any number of scenarios may occur as to where the break is located. Fractures can also occur in multiple locations. Because of this complexity, an X-ray must be taken and a doctor must tailor treatment on an individual basis.
Symptoms of Ankle Fracture
There are a number of symptoms that may indicate an ankle fracture. However, these symptoms may also occur in a sprain or torn ligaments, which is why X-rays will be needed to rule out other causes. Pain, swelling, bruising, inability to put weight on the ankle, and deformities are all possible symptoms.
Depending upon the severity of the fracture, some breaks can be healed simply with a cast, while others may require surgery to stabilize the ankle and help prevent arthritis issues down the line. Here are the typical treatments for an ankle fracture.
1. Ice and elevation: Swelling will most likely occur with a break. Elevating the foot and applying ice helps reduce swelling and prevent damage to surrounding tissues.
2. Reduction: If there is displacement of the ankle joint, a reduction --where they re-align the joint and bones -- will be performed. This may be done under mild anesthesia.
3. Surgery: Surgery is necessary for many types of ankle breaks. Surgery will be discussed on an individual basis and may require the insertion of metal hardware (such as plates, wires, pins, or screws) to further stabilize the bones. Surgery will be done under full anesthesia and there will be one or more incisions to reach the bones. The hardware may be left in unless it poses discomfort, or removed after the stabilization is complete.
4. Immobilization: With or without surgery, some type of immobilization of the ankle will occur. This may be achieved with a splint, short-leg cast, removable cast, or whatever the orthopedist recommends. There may be several different immobilization methods used as swelling diminishes. For example, a patient may start out in a splint, progress to a cast, then be given a walking support boot.
5. Non-weight bearing: There will be a portion of time where no weight will be allowed on the injured ankle. Crutches, canes and walkers can be used to support the body and prevent weight from being placed on the foot. Typically, it takes 6 to 8 weeks for a fracture to heal in an adult. However, this doesn't mean the patient will be up on his or her feet after this point in time. Many doctors prefer little to no weight be placed on a fracture for several months. It could be 3 to 4 months before a normal shoe can be worn. It's important not to place weight on the fracture until the doctor advises, otherwise treatment may be delayed and reinjury may occur.
6. Physical therapy: The doctor may recommend physical therapy to help strengthen the muscles surrounding the ankle and improve flexibility of the joint.
It's important not to get discouraged during ankle fracture treatment. With time, most of the range of motion and strength of the ankle will resume. However, this will not happen overnight. Even after the doctor has given his or her approval for weight bearing, there may be tenderness, swelling and the need to limp on the foot for some time after. It could take up to one year for the swelling to diminish as much as possible.