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Ankle fracture (fibula) Introduction-

A fracture is a partial or complete break in a bone. Fractures in the ankle can range from the less serious avulsion injuries (small pieces of bone that have been pulled off) to severe shattering-type breaks of the tibia, fibula, or both.

Ankle fractures are common injuries that are most often caused by the ankle rolling inward or outward. Many people mistake an ankle fracture for an ankle sprain, but they are quite different and therefore require an accurate and early diagnosis. They sometimes occur simultaneously.

The ankle joint is composed of 2 joints: the true ankle joint and the subtalar joint.

The true ankle joint contains the tibia (medial wall), fibula (lateral wall), and talus (the floor upon which the tibia and fibula rest). The true ankle joint allows dorsiflexion and plantar flexion or the “up and down” movement of the ankle. The foot can be made to point toward the floor or toward the ceiling via the true ankle joint.

The subtalar joint consists of the talus and the calcaneus. The subtalar joint allows the foot to be inverted or everted, that is, the sole of the foot can be made to face inward (inverted) or face outward (everted) through the subtalar joint.

During evaluation of ankle fractures, the mechanism of injury (eg, eversion, inversion, dorsiflexion, plantar flexion), associated injuries (eg. vascular, ligamentous, capsular), the need for immobilization (eg, application of a splint), and the need for referral to a specialist for further treatment or evaluation (eg. additional immobilization, surgery, or rehabilitation) are all important components of care.

Causes –

• “Twisting” or rotating your ankle
• “Rolled” your ankle
• Tripping or falling
• Impact during a car accident

Since there is such a wide range of injuries, there is also a wide range of how people heal after their injury.

Symptoms-

An ankle fracture is accompanied by one or all of these symptoms:

• Pain at the site of the fracture, which in some cases can extend from the foot to the knee
• Significant swelling, which may occur along the length of the leg or may be more localized
• Blisters may occur over the fracture site. These should be promptly treated by a foot and ankle surgeon.
• Bruising that develops soon after the injury
• Inability to walk-however, it is possible to walk with less severe breaks, so never rely on walking as a test of whether a bone has been fractured
• Change in the appearance of the ankle – it will look different from the other ankle
• Bone protruding through the skin-a sign that immediate care is needed. Fractures that pierce the skin require immediate attention because they can lead to severe infection and prolonged recovery.

Diagnosis-

Following an ankle injury, it is important to have the ankle evaluated by a foot and ankle surgeon for proper diagnosis and treatment. If you are unable to do so right away, go to the emergency room and then follow up with a foot and ankle surgeon as soon as possible for a more thorough assessment.

Besides a physical exam, X-rays are the most common way to evaluate an injured ankle. X-rays may be taken of the leg, ankle, and foot to make sure nothing else is injured.

Depending on the type of ankle fracture, the doctor may put pressure on the ankle and take a special X-ray, called a “stress test.” This X-ray is done to see if certain ankle fractures require surgery.

Sometimes, a computed tomography (CT, or CAT) scan is done to further evaluate ankle injuries.

For some ankle fractures, magnetic resonance imaging (MRI) may be done to evaluate the ankle ligaments.

Non-surgical treatment-

Treatment of ankle fractures depends upon the type and severity of the injury. At first, the foot and ankle surgeon will want you to follow the R.I.C.E. protocol:

• Rest: Stay off the injured ankle. Walking may cause further injury.
• Ice: Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
• Compression: An elastic wrap should be used to control swelling.
• Elevation: The ankle should be raised slightly above the level of your heart to reduce swelling.

Additional treatment options include:

• Immobilization. Certain fractures are treated by protecting and restricting the ankle and foot in a cast or splint. This allows the bone to heal.
• Prescription medications. To help relieve the pain, the surgeon may prescribe pain medications or anti-inflammatory drugs.

Surgical treatment-

• Doctors usually place a splint on the injured ankle for a few days to 2 weeks until the swelling decreases around the joint. The type of fracture and the stability of the fractured joint will determine the type of splint that will be used, or whether surgery is needed.
• If the ankle bones are not aligned properly, the doctor may realign them before placing the splint.
• Surgery will also be needed if any bone has broken through the skin. If the bone breaks through the skin, the fracture is then called a compound fracture. This is more serious than a simple fracture.
• Some minor ankle fractures do not require a splint or cast. In these cases the fracture will be managed as an ankle sprain.
• Because these fractures are very small, they heal well with this management.
• With any injured ankle, however, patients should not bear weight until a cast is placed or until the ankle joint is pain free; check with the orthopedist about when weight bearing should be attempted.

• After the swelling decreases and the patient is reexamined, an orthopedic doctor or a primary care doctor may place a better-fitting cast on the ankle. Depending on the type of fracture, the patient may be placed in a walking cast, which can bear some weight, or the patient may need a non-weight-bearing cast that will require the use of crutches to assist with walking.
• Depending on the degree of pain, the doctor may prescribe pain medication. The patient should use the pain medication only as needed. Do not drive or operate heavy machinery while using these medications.

Follow-up care-

Follow-up care for an ankle fracture depends on the severity of the fracture; consultation with an orthopedist is recommended for most fractures. In some instances, a surgeon may need to be consulted, especially if there is any vascular compromise due to the fracture.

The patient may need emergency surgery, next-day follow-up, or follow-up in 1-2 weeks with an orthopedic doctor.

The patient may require follow-up with a family doctor.

• If the patient’s injured ankle was splinted on the initial visit, he or she will probably need to have a cast placed on the ankle during the follow-up visit.
• Recovery time varies depending upon the type of fracture or need for surgery. The average fracture requires 4-8 weeks for the bone to heal.
• With severe ankle injuries, the doctor may recommend physical therapy for rehabilitation after the acute phase of healing.

Why Choose Joint Replacement Surgery Hospital India for Ankle Cartilage Surgery?

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

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