Fractured Ankle

What is a fractured ankle?

The ankle joint is made of three bones – the tibia (shinbone), fibula (calf bone), and talus (a small bone between the tibia, fibula, and the heel bone). In a fractured ankle, there can be a break in any of the bones of the ankle joint. The fracture can occur in a single bone (a common occurrence), which does not impair daily activities, or it can be a severe fracture that dislocates the ankle, prompting medical attention. A fractured ankle can be seen in any age group. A frequently occurring type of ankle fracture is a fracture of the lateral malleolus (55% of all ankle fractures). In a study conducted in the US, the incidence of ankle fractures was found to be 187 fractures per 100,000 person-years. In India, the yearly incidence is found to be 122 fractures per 100,000 individuals.

What are its main signs and symptoms?

The most common presentation of fractured ankle includes:

• Unbearable pain that can progress from the affected site to the knee.
• Localised or entire leg oedema (swelling).
• Scaly blister formation.
• Inability to walk.
• Bone poking through the skin.

Tenderness may occur, and the person may not be able to bear weight on the affected foot. A fractured ankle can be easily confused with a typical sprain.

What are its main causes?

The most frequently encountered causes for ankle fracture are falls, sprained ankle, and the damage sustained while playing sports. Patients who have high blood sugar levels may not realise they have an injury to their body due to the damage to their sensory nerves, which can cause further damage to the bone and surrounding structures. Smoking and high body mass index (BMI) ratio are often linked to fractures of the ankle.

How is it diagnosed and treated?

The physician may check the history of the traumatic incident that caused the fracture along with any concomitant medical condition, clinical features, and ask for further evaluation of the affected ankle. The fracture may be analysed through X-rays. Other tests include CT scan and MRI scans. A stress test is conducted to see if there is any need for surgical intervention.

Treatment strategies include:

Surgical method: For dislocated ankle or protrusion of bone through the skin.

Non-surgical methods:

• Use of ice and elevating the affected leg, as it reduces pain and swelling.
• Splint use can provide help to the affected ankle if there is no dislocation of the bone.
• Taking complete rest and avoiding placing weight on the foot.
• Foot immobilisers or use of plaster may prevent any further movement.

Some analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) may be used to control pain and inflammation. Physical therapy may accompany the medication regimen for a speedy recovery.

A fractured ankle is not a long-term condition and can be healed through proper care and management of the affected foot.

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4. Clinical Trials. Operative Versus Non Operative Treatment for Unstable Ankle Fractures. U.S. National Library of Medicine. [internet].
5. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Bone fractures