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Ankle fracture: Types, Symptoms & Causes
An ankle fracture happens when one or more than one bone that makes up the ankle joint- and probably its ligaments break at or close to the joint.
Every year, 184 persons out of every 100,000 withstand ankle fractures. Emergency rooms witness 1.2 billion visits in 2003 due to ankle fractures alone. This number has been increasing and the broken ankles have been getting more severe in the last few years.
Types of ankle fractures
Ankle fractures can be categorized into 5 main types:
- Lateral malleolus fracture :– The lateral malleolus is the point situated on the outside of the leg where the fibula articulates with the talus. A lateral malleolus fracture is a broken distal fibula.
- Medial malleolus fracture :– A medial malleolus fracture is a tibia fracture analogous to the lateral malleolus fracture of the fibula. It is a fracture of the distal tibia.
- Posterior malleolus fracture :– It is very infrequent that only the posterior malleolus- the actual bony protrusion of the tibia is broken.
- Bimalleolar fracture :– If two ankle bones are fractured, it is known as a bimalleolar fracture. This is usually a combination of a medial malleolus and lateral malleolus fracture. This kind of fracture will lead to an unstable ankle.
- Trimalleolar fractures:– If all 3 of the malleoli (the medial, lateral and posterior) have been broken, it is a trimalleolar fracture. This kind of fracture will lead to a very unstable ankle.
The many common symptoms across all kinds of ankle fractures are:
- Extreme pain in the ankle that may “radiate” out to the foot and knee
- Swelling in the ankle and, sometimes leg
- A problem in walking or complete inability to walk (don’t use this as a test, as it can worsen the injury)
The symptoms of an ankle fracture may be mistaken for the symptoms of other medical situations (sprained ankle, talus fracture, etc.). Ensure you consult a doctor to know if you have an ankle fracture and get the suitable treatment. The treatment may include surgical intervention that requires orthopedic instruments used by the surgeons.
An ankle fracture is an outcome of too much stress being put on any or all the bones of the ankle joint. The causes of the ankle fractures are:
- Ankle twist :– If your foot twists far to the side, turning around your ankle
- Ankle roll :– If your foot rolls up on its side during you are putting substantial weight on it
- A fall or a trip :- If you suddenly lose your balance and awkwardly try to catch yourself with your feet.
- Overextension of the ankle joint :- If you try to swing your foot down too far in a parallel arc with your leg, as a may be ballerina
- Extreme impact :– If the joint sustains a serious blow, as it may if are in an automobile accident or you come down on your feet from a height
Without suitable care and medical intervention, an ankle fracture can lead to arthritis. You have an especially high risk of ultimately getting arthritis if, after the injury, your ankle appears misshapen. If the break is serious, you might see a bone poking out of your skin. If this is the case, you must take immediate medical care, as this kind of ankle fracture can lead to severe infection.
Treatment for Ankle fracture will be decided by the Orthopedic Surgeon after proper examination of the injury using X-ray or CT scan or MRI. He may opt for Surgical Intervention and use of trauma Implants like Malleolar Screws, Wires, Plates and Screws if other options are not effective.
Surgery is followed by planned Post-Operative Care including Physiotherapy so that the patient regains proper movement of the ankle.
Injuries to children leading to fracture of femoral bone are quite common. Non-surgical treatment option has been effective for common Femur Fractures. Selecting treatment method for femur fractures is dependent on the age of the child since the displacement (separation of the bone ends) that can be accepted depends on the child’s age and even widely displaced fractures have healed in young children.
Usually, cast treatment is adopted for treating Femur fractures in infants and toddlers. A Pavlik harness may be preferred instead of a Spica cast in early infancy.
The rapid growth of bone in young children does not require the bone ends to be perfectly aligned. Over time, the bone remodels to a shape, where it may not be evident that the bone had been injured. Spica casting for about 4 to 6 weeks will be adequate for bone healing in case of most infants and toddlers.
Spica casting is usually adequate for younger children (Up to the age of 6) to treat a femur fracture. As children get older, the duration of casting may be slightly longer, but the bone still has excellent potential for healing.
For children in the 5 to 7-year age bracket, Orthopedic Surgeon has to make a decision in consultation with the parents for applying the best technique to heal the bone injury. While a Spica cast is a popular option in treating children, Doctor may decide to insert flexible rods inside the bone. The pros and cons must be well understood from the treating Doctor.
In Later Childhood
While there is no clear cutoff for spica casting option becoming less practical, but one must evaluate options with the surgeon. The surgical treatment options commonly adopted for femur fractures are:
- Flexible Rods: A flexible intramedullary rod is the most common treatment option for older children (age 7 – 12). These flexible rods are inserted just above the knee into the medullary canal of the femur bone and easily removed after treatment. The rods do not cross the growth plate. As the rods are not rigid, they cannot support the child. These young children heal very quickly, and the rods do not cause problems.
- External Fixation: External fixation uses a rod outside the patient’s body which is attached to the bone with long pins or screws. The external fixators are often used with open fractures or when the fractured bone is in many pieces (comminuted). Due to good results with the flexible rods, the use of external fixators is limited.
- Standard Rods: In an adult, Intramedullary rod is the standard treatment for a femur fracture. Once a child’s growth plates have closed, only then this type of rod should be used. Around the ages of 11 to 14, most femur fractures will be treated is the same way as they are treated in an adult.
Above are general approaches for the treatment of common femur fractures but deciding the best treatment option in a situation depends not just on the age but on a number of factors of individual circumstances of the child, which may alter the treatment approach.