Ankle Injuries

Ankle Injuries include Ankle Fractures and Ankle Sprains

Anatomy

The ankle is made up of the bones known as the tibia, fibula, and talus.  The leg bone or the tibia is located directly above the talus and the fibula is adjacent to the tibia.  This structure is held together by ligaments and other fibrous tissue.  The force needed to damage these tissues is typically high but it depends on the strength of the bone and the age of the Ankle Injuriespatient. When these forces become to high for the ankle structures, ankle injuries occur.

Ligaments are made up of fibrous tissue and they help connect bones to each other.  They allow for stability of the ankle and help the body determine where the ankle and foot are in relationship to the rest of the body.  The ligaments have sensors embedded in them and these sensors inform the brain as to where the ankle and foot are in relationship to the ground.  The ligaments help to prevent over straining of the joints and bones and allow for proper functioning of the ankle.  The tendons of the foot ankle and leg also play an important role in stabilizing the ankle.  The combined efforts of the ligaments and tendons allow the ankle to undergo strain without being damaged but if too much force is exerted them then they may fail and result in ankle injuries. As you can see the ankle has many structures and ankle injuries are common as a result.

What causes an ankle fracture and ankle sprain?

The main cause of ankle injuries such as ankle fracture or sprain is the straining of the joint caused by rotating and rolling of the ankle.  When the ankle is rolled the ligaments will only handle so much stress.  Once the ligaments fail the bones of the ankle joint will press against each other causing a fracture.  This is the most common cause of an ankle fracture.  The ankle can also be fractured by other forces such as falling in a hole or getting kicked in a soccer game.  Car accidents can cause very severe ankle fractures. 

How do you treat ankle fractures and ankle sprains?

Ankle Fracture Treatment

Ankle fractures can be treated conservatively if the fractured bone is not completely out of place.  The doctor will typically take three  x-rays of the ankle to determine the type of fracture and the amount of separation of the bones.  The doctor will then decide whether or not conservative treatment can be used.  If conservative treatment is an option then the patient will be given crutches or a knee scooter and stay off of the injured ankle.  A cast or walking boot may be used in order to protect and stabilize the ankle so further injury will not occur. 

If the fracture is too far apart then surgery may need to be performed.  The doctor will place the bones back in place and will use screws and plates to hold the fracture fragments together.  Recovery from ankle surgery is typically three to six months.  Physical therapy is started once the bone is healed on x-ray. 

Ankle Sprain Treatment

Ankle sprains are typically treated with conservative methods and occasionally with surgery.  Typically a walking air boot or casting will be used to immobilize the ankle and allow the soft tissues and ligaments to heal.  After six to eight weeks the patient may then use an ankle brace to prevent overstraining of the ankle while healing.  The patient will undergo physical therapy to strengthen the muscles of the foot and ankle as soon as possible.

Surgery is considered if the ankle sprain is severe.  If the ligaments are ruptured then repair of the damaged ligaments can speed up the healing process and also improve function.  The doctor may use a ligament graft to reinforce the damaged ligaments around the ankle.

Regenerative Medicine

The most advanced treatments for ankle injuries include regenerative medicine. These treatments include prolotherapy to naturally heal damaged ligaments. Platelet rich plasma can also be an excellent option. These treatments can help you avoid the use of steroids and surgery while healing naturally.

How do you prevent ankle fractures and sprain?

Ankle injuries can be prevented by wearing proper shoes for the activity being performed.  It is not wise to play basketball in flip flops or run in high heels.  Watching where you step is also a simple way to prevent injury.  More often than not a patient will break their ankle by simply missing a step when going down the stairs.  If the patient has suffered multiple ankle sprains then wearing an ankle brace during physical activity will help to stabilize the ankle and prevent strain. Custom orthotic devices can be useful after an ankle injury or to prevent ankle injuries.

ALSO SEE: Ankle Sprains

Written and Provided by Advanced Podiatry

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