Ankles Fractures

Ankle fractures are the most common type of fractures treated by orthopedic surgeons (account for 9% of fractures). The ankle consists of the articular surfaces of the talus, tibia and fibula, as well as its binding ligaments and capsule. The tibia is the shinbone and is located on the inner, or medial, side of the leg, the fibula is located on the outer, or lateral, side of the leg and the talus is a small bone that sits between the heel bone (calcaneus) and the tibia and fibula. The distal ends of the tibia and fibula bones are also known as the medial and lateral malleoli, respectively. Ankle fractures are common injuries that are most often caused by the ankle rolling inward or outward.

The contribution of the articular surfaces, ligaments, capsular and ligamentous structures and the ankle function and stability are influenced by changes in load characteristics and joint position and altered in response to injury. Doctors classify ankle fractures according to the area of bone that is broken. The ankle fractures 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. These fractures can be caused by a car accident, one false move, diseases such as imperfect osteogenesis (failure in the bone development) and rheumatoid arthritis (inflammation of the joints) and by sports injuries, such as basketball or football. An ankle fracture is accompanied by one or all of these signs and symptoms: immediate and severe pain, significant swelling, bruising, inability to walk, cannot put any weight on the injured foot, and change in the appearance of the ankle so that it differs from the other ankle.

The goals of treatment are the fracture healing and the recuperation of the ankle's movement and function. The treatment will depend of the diagnosis which can be done by an arthrogram, bone scan, computed tomography (CT), x-joint (radiography of articulation) or with a MRI (magnetic resonance imaging). Treatment of ankle fractures depends upon the type and severity of the injury (lateral malleolus fracture, medial malleolus fracture, posterior malleolus fracture, bimalleolar fractures or bimalleolar equivalent fractures, trimalleolar fractures or syndesmotic injury). For some ankle fractures, surgery is needed to repair the fracture and other soft tissue related injuries. No matter if it is broken or not, it's important to follow the "RICE" protocol (rest, ice, compression and elevation). Also, immobilization and medication can be needed. Obviously, physical therapy plays an important role in recovery. 

To conclude, it is important to follow your surgeon’s instructions after treatment. Failure to do so can lead to infection, deformity, arthritis, and chronic pain.

Bibliography: 

American College of Foot and Ankle Surgeons. (n.d). Ankle Fractures. Retrieved from ACFAS: http://www.foothealthfacts.org/footankleinfo/ankle-fracture.htm

American College of Foot and Ankle Surgeons. (2006). Ankle Fractures. ACFAS, 1-2.

American Orthopaedic Foot & Ankle Society. (2015). Ankle Fracture. Retrieved from AOFAS: http://www.aofas.org/footcaremd/conditions/ailments-of-the-ankle/Pages/Ankle-Fracture.aspx

Crist, B., Dunbar, R. P., & Fischer, S. J. (March, 2013). Ankle Fracture. Retrieved from Ortho Info: http://orthoinfo.aaos.org/topic.cfm?topic=a00391

Cunha, J. P. (March 13, 2015). Broken Ankle (Ankle Fracture). Retrieved from Emedicine Health: http://www.emedicinehealth.com/ankle_fracture/article_em.htm#broken_ankle_ankle_fracture_overview

Education for ABC Health Program. (n.d.). "Fractura de Tobillo". 1-3.

Varela, B., Federico, C., Rainero, V., Salvo, J. N., Ventura, E. A., & J. I. (n.d.). "Fracturas de Tobillo" . 1-20.