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Ankle Injury : FractureThis refers to a break or fracture to one or more of the bones which comprise the ankle joint. Often, the fracture involves one or both bones of the lower leg (fibula and tibia). The outer prominence of the ankle joint is the point at which a fibula fracture will occur most often. The inner prominence is the location where tibia fractures occur. A tibia fracture is less common and more serious. Common symptoms include: pain, swelling and tenderness to either (or both) ankle prominence. More serious fractures may be evident by deformity of the joint. Pain is often present while at rest, in addition to any attempt at walking. Evaluation includes: examination to check for normal motor (movement) and sensory (feeling) functions. Bone x-rays will determine the type of fracture and its severity. Movement of fractured (bone) fragments out of their normal anatomic position is referred to as displacement. The degree of displacement is a key factor in judging the overall severity of the fracture. Analysis of these factors will guide the Orthopaedic Surgeon to the appropriate form of treatment. More serious fractures, involving gross displacement of fracture fragments, may require an operation to reattach the fragments. Untreated (severely) displaced fractures can result in permanent deformity, stiffness, and improper joint function. In most cases, fractures which include a laceration (or cut) overlying the broken bone, require surgical management. Treatment includes ice packs and elevation to reduce swelling. Splinting (half cast) may be useful early on to allow the injury "room to swell." Eventual circular cast application is adequate treatment in most cases of ankle fracture. Crutches, to maintain nonweight bearing on the injury, are crucial. Bearing weight too early could result in an undesirable displacement of the fracture site. Aspirin or anti-inflammatories (ibuprofen) are helpful for pain control. The majority of ankle fractures heal in 6 weeks. Children will frequently have more subtle fractures (Salter-Harris fracture) of the ankle that are not always noted on x-ray. Here, the fracture can occur in growth areas on the bone and should always be managed with splinting and crutches even if the x-rays are normal. The Orthopaedic Surgeon is the expert in the management of the ankle fracture.
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