A fracture, usually in either side of the ankle, often including a total tear of one or more ankle ligaments. A temporary dislocation of the ankle joint may also occur. Ankle sprains are among the most common injuries in sports.
BODY PARTS INVOLVED
- Lowest part of the lower leg bones (tibia and fibula).
- Ligaments on either side of the ankle that support the ankle joint.
- Three main bones of the ankle joint (talus, tibia, and fibula) may be involved with the dislocation or sprain.
- Blood vessels, nerves, periosteum (covering of bone), and other soft tissue close to the injury site.
Causes
Stress Imposed from either side of the ankle joint that temporarily forces or pries the ankle or heel bone (talus) out of its normal socket. The ligament or ligaments that normally hold the joint in place are stretched and torn
Signs & Symptoms
- Severe ankle pain immediately after injury.
- Popping or feeling of tearing in the outer or inner part of the ankle. Sometimes there will be a sensation that the ankle joint is dislocated or has popped back into joint.
- Severe tenderness at the injury site.
- The injured person usually falls at the time of injury and has difficulty walking.
- General swelling throughout the ankle and foot.
- Bruising immediately or soon after injury.
Treatment
Follow your doctor’s instructions. These instructions are supplemental.
- Use instructions for R.I.C.E., the letters of rest, ice, compression and elevation.
- Following surgery, the doctor may apply a stirrup boot splint from below the knee to the toes. Stirrup boots are less likely to cause problems with swelling than an immediate cast may cause. This will support the ankle effectively enough to walk on crutches, but you should not bear weight on the injured ankle.
- When the swelling subsides several days later, sutures may be removed. The splint Is replaced by a walking-boot cast for 10 to 21 days. Start walking on the walking cast immediately.
- After the cast has been removed, strapping or a brace will be necessary for at least 6 weeks.
- Bathe and shower as usual after the cast is removed, even if sutures are still in place.
- After cast removal, use frequent ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a baseball. Do this for 15 minutes at a time, 3 or 4 times a day.
- Apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers or heating pads.
- Take whirlpool treatments, if available.
- Gentle massage will frequently provide comfort and decrease swelling.
Home Diet
- Drink only water before manipulation or surgery to treat the fracture. Solid food in your stomach makes vomiting while under anesthesia more hazardous.
- During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
Prevention
- Engage in vigorous presport strengthening and conditioning.
- Wear high-top athletic Shoes for contact sports.
- Have adequate taping (midfoot to midcalf) before participation in activities at risk.
- Wear supportive elastic ankle wraps (not as good as tape, but better than nothing).
- Support the ankle well during sports activities for 12 months after any significant ankle injury.
Useful References