Ankle sprains are a common injury occurring 27,000x/day! Low grade injuries are most common which most require only supportive care and physical therapy to prevent future injuries. High grade sprains are more concerning and may need ligament repair or reconstruction.
A “break” is the same thing as fracture.
Simple or Clean break – means the bone breaks into two fragments which can be non-displaced (in alignment) or displaced (out of alignment). Both categories can possibly be treated conservatively with a tall walking boot which allows the patient to be weight bearing. Surgical intervention may be considered depending on the displacement of the fragments.
Comminuted fractures – multiple fragments – require longer healing times until walking is allowed.
Compound or open fracture is a medical emergency! Bony fragments that penetrate through the skin can cause a high risk of infection in addition to decreased likelihood of healing correctly.
Most times the injury is fairly stable and you can walk right away in a tall boot.
More involved fractures can cause abnormal migration of your foot away from the shin bone and require surgery to restore ankle function.
Sometimes fracture fragments do not penetrate skin, but underlying soft tissue injury is quite severe. It is not seen on X-ray but manifests itself in severe swelling, fracture blisters, and “skin-at-risk”—permanently stretched blanched skin that is being compressed by bone fragments and is at risk of breaking down. In some of these instances, patience and watchful waiting for the right time to operate are hugely important. In others, immediate temporary stabilization with an external fixator allows for the skin and muscle swelling to decrease and will therefore improve success of a definitive procedure that is performed a few weeks later.
Although less common than ankle sprains, midfoot sprains – also called Lisfranc joint injuries – can be potentially career ending for athletes and cause the arch of the foot to lose stability. Diagnostic treatment would be to begin by obtaining an X-ray of the foot – with as much weight placed on the foot as the patient can comfortably tolerate. This gives us a glimpse into the functional state of smaller joints of the foot as the patient stands. However, Lisfranc joint injuries are often insidious and advanced testing such as an MRI of the foot is needed to evaluate the full extent of the injury. Midfoot sprains vary in their severity. After a thorough evaluation of the foot, we typically recommend immobilization and limited weight-bearing if the injury is mild, other times surgical repair is necessary. Infrequently, these joints are damaged to the point when direct repair is insufficient and primary midfoot fusion is performed. This allows the remainder of the foot and ankle to function normally and patients are able to walk without a limp once they recover.
Schedule Your Appointment with Specialty Orthopaedics
We specialize in diagnosing and providing the appropriate treatment for foot and ankle injury. Whether you are suffering from rheumatoid arthritis, infection of the joint, or chronic injuries, Specialty Orthopaedics can provide you with the expertise and knowledge to address the problem. Learn more about your or your loved one’s ankle injury by contacting us today.