Ankle fractures

These fractures concern the two malleoli, the lateral and the medial, which are actually the lower ends of two bones, the tibia and the fibula, which support the ankle as the weight of the body is transferred on it during walking.

When the malleoli are fractured, the articular surface that carries body weight onto the ankle is disrupted. That is why ankle fractures must be properly aligned, as they can cause arthritis.

Ankle fractures

 

What is an ankle fracture?

Among ankle fractures, the fracture of the lateral malleolus is usually accompanied by a fracture of the medial malleolus (bimalleolar).

Ankle fractures

This is because the two bones form a pillar with two supporting elements. When one of them is broken, the other has to break as well (sometimes instead of breaking, the deltoid ligament is ruptured or the fibula head is fractured (Maisonneuve fracture)).

Ankle fractures

 

How is it treated?

In ankle fractures, since the injured joint (luxation – subluxation) is disrupted, the patient is unable to stand on his/her foot and walk and the joint appears very swollen and deformed.

During palpation we observe increased sensitivity on the lateral or medial malleolus. The patient cannot perform normal movements, i.e. dorsal extension and plantar flexion.

Ankle fractures

Ankle fractures

 

How is it treated?

If the lower limb looks like it has “slipped” out of its position, it should be aligned back into place (realignment) and then fixated with a splint.

Until we get to the hospital, the leg should be positioned at a higher level! Ankle fractures cause significant edema and large blisters in the skin, making early surgical intervention impossible. In addition, they can rarely cause skin necrosis.

The treatment of a malleolus fracture, bimalleolar or trimalleolar (if a part of the tibia is removed) is surgical to restore bone alignment and joint anatomy.

Ankle fractures

Ankle fractures

Otherwise the joint will develop arthritis. After surgery, the patient should avoid charging the leg, first with a splint and two crutches for 2 weeks and then without a splint, performing strengthening exercises for another 4 weeks.