Patient Education

Broken Ankle

Description

Breaking things can be no fun (although small children seem to enjoy it), whether the broken thing is an expensive china dish, an egg dropped to the floor, or your computer. Breaking bones can be especially unpleasant, since recovering from these breaks often takes many weeks, even months. A break in the ankle joint can be particularly nasty, since it’s pretty difficult to walk around when your ankle is all discombobulated. You may take your ankles for granted, but you’ll find you miss them terribly when they’re no longer working properly.

When people refer to the ankle, they’re really talking about an area where three different bones move around: the tibia (often called the shin bone), the fibula (a more slender bone to one side of the tibia) and the talus, which is a foot bone. The ankle is where these three bones meet and interact with one another. Fractures of the ankle usually take place in either the fibula or the tibia, and if you’re really unlucky, both bones may break. Such breaks can range anywhere from a relatively minor cracking of the bone or small bits of bone breaking off, to major breaks where the bone actually pierces and protrudes through the skin. Treatment and recovery time will vary greatly depending on the type of break you experience.

Adding a sort of insult to injury, your bones may not be your only problem when you break your ankle. Whatever caused the break in the first place may also have torn the ligaments around the area, which may require additional treatment. (Plus, it makes the whole thing hurt more, which is about the last thing you need.)

Ankle breaks usually come about as a result of some sort of event or action (as opposed to a gradually developing condition). These might include falling, tripping, twisting or rolling your ankle (something it is decidedly not designed to do), a weight of some sort falling on your ankle, or (and these most often cause crushing types of breaks) a car accident. The most common cause of a broken ankle is twisting it, so you’ll want to be particularly careful when twirling about.

Occasionally, breaks may happen when people overuse their feet. Usually such breaks (referred to as stress fractures) are small cracks in the bones. Running long distances or having osteoporosis make you more vulnerable to experiencing this type of fracture.

Symptoms

First off, you should know that having a broken ankle doesn’t always mean you won’t be able to walk on it. So if you’re able to take a few steps without collapsing, that doesn’t necessarily mean your bones are nice and whole. In fact, with some minor fractures, you may be able to walk relatively well (‘relatively’ being the key word, here). In short, if you’ve injured your ankle, you really ought to get it looked at; don’t assume you’re fine just because you aren’t hopping around on one foot. However, if you find you’re not able to put weight on the ankle, then you most definitely should get it seen by your podiatrist.

Some other symptoms you should look for include pain (which should be pretty obvious-hello, you’ve just broken your ankle, people), which may actually occur at any point on your leg between your foot and your knee. The pain will likely occur immediately after the break, and will probably be of the throbbing sort. You may notice that the pain reduces slightly as you rest the ankle, but increases if you move it or put weight on it.

You may also experience swelling in the area (caused by increased bloodflow sent to try to repair the injury), although again this swelling may not be confined just to the ankle and may extend up your leg. Blisters and bruising may also appear, making your ankle look really quite pathetic. (The blisters should be seen to by your foot doctor, by the way, although putting a compression bandage over them may reduce the pain a little.)

By comparing it to your other (hopefully uninjured) ankle, you may notice that the injured one has begun to look a bit distorted, either because of swelling or because the bones are now out of alignment. In the most serious type of break (sometimes called a compound fracture), you’ll see bone poking out from the skin. This is very serious, since the exposed bone and the flesh around the wound is vulnerable to infection. See your doctor immediately if this occurs.

Diagnosis

If you’ve injured your ankle in any way, and especially if you suspect you may have broken it, you really ought to see your podiatrist as soon as possible. When you get in to see the foot doctor (after having come in very soon after the injury because you’re conscientious like that), he or she will probably examine the area visually and touch the ankle to see what parts are most painful.

In order to firmly diagnose a fracture, your podiatrist will also likely suggest some sort of imaging to get a look at the bones themselves. This may be accomplished by getting an X-ray, a CT (or Computerized Tomography) scan, an MRI (Magnetic Resonance Imaging), or a bone scan. (Bone scans use a small amount of radioactive material to locate breaks in the bone.)

Treatment

Right after the break, and before you’re able to get to the podiatrist’s office, you can do a few things to reduce the pain and swelling a little. Use the RICE method (Rest, Ice, Compression and Elevation) to decrease bloodflow to the area. Don’t soak your injured ankle in hot water, since this will just increase the blood and pressure in the area, making the swelling and pain worse.

Once your foot doctor diagnoses a break, he or she will help you determine the best method of treatment to insure that your bones heal nicely. Some non-surgical methods generally revolve around immobilizing the ankle so the bones will stay in their proper positions and knit together properly. The podiatrist may do this by putting a splint on the ankle, or by applying a cast. He or she may also give you a prescription for medications to manage the pain and swelling.

If the break is bad enough, your injury may require surgery to set things to rights. Surgery on broken bones generally involves inserting metal pins, screws or plates into the bone to keep the fragments in place as they knit back together. It may sound kind of strange (and a little disgusting) to have bits of metal inside you, but it’s a remarkably effective way to get your bones back to the way they’re supposed to be.

Always remember-follow the instructions your podiatrist gives you to the letter, and follow up with him or her on a regular basis. Fractures usually heal pretty slowly, and you don’t want to have to go through the entire process again.