Ankle Sprain or Fracture
Ankle Sprains and Fractures
Ankle sprains and fractures are common injuries that can effect both very active and sedentary people. At Podogo Foot Clinic, we can investigate the injury with imaging, and treat with both conservative and surgical methods.
What is the difference between an ankle sprain and ankle fracture?
An ankle sprain is when the soft tissues around the ankle are injured. These structures involve the ligaments and tendons. Usually sprains make a good recovery but sometimes the ankle feels less stable after recovery. An ankle fracture is when there is a bone injury that causes one or more of the bones to break.
How to identify an ankle sprain or fracture?
An ankle sprain or fracture will occur after an injury. The ankle will swell and may be painful to move or bear weight on. Sometimes it is difficult to discern whether there is a fracture, imaging may be required to help with this. The less you can bear weight because of pain, indicates there is an increased risk of fracture.
A podiatrist should be able to help you with a diagnosis and a recovery plan. If there is a fracture you may need to see a surgeon who can assess whether the fracture needs fixating.
Home remedies for ankle sprains and fractures
The general advice for injuries is RICE which stands for Rest, Ice, Compression and Elevation.
Following this guide will help reduce the loading and swelling which should encourage recovery. If you are concerned you should see a specialist.
Treatment for an ankle sprain
As listed above, the first treatment is to follow the RICE guidelines for Rest, Ice, Compression and Elevation.
In most cases a sprain will settle in six weeks. If not, imaging can be requested.
Often an ankle brace can help with stability over the recovery phase and sometimes orthotics can be made to fit your shoes that encourage ankle stability. Topical or oral antiinflammatory medication can help with reducing the initial swelling.
Treatment for an ankle fracture
A fracture will be confirmed with imaging. The exact treatment will depend on the type and severity of the fracture and whether any soft tissue is also damaged.
In the simplest of cases, a cast and offloading with crutches will be required. In other cases surgical repair of torn ligaments or fixation of bone may need to be carried out.
When is surgery advised for a fracture?
Fractures are mainly divided into whether they are aligned or displaced.
If the fracture is clean and well aligned then offloading it overtime should allow it to heal naturally with minimum intervention.
However, if the fracture is displaced, it will need surgical intervention to correct the alignment and allow it to heal in the correct position.
Fractures can be identified with X-ray, CT or MRI imaging, this will confirm the alignment and extent of any fracture. The bones typically affected are the fibular, tibia and talus. The imaging preference will be decided by the clinician who you see at the time.
If surgery is required the alignment will need to be corrected using screws, plates or rods. You will be non-weight bearing for at least 2 weeks and then after this time sutures are removed. Bone takes at least six weeks to heal so usually after suture removal you will very gradually increase activities over the next few months.
When is surgery advised for an ankle sprain?
A sprain is when soft tissues have been damaged. Surgery is not usually required for a sprain unless ligaments or tendons have been ruptured or there’s instability. Instability can risk further injuries and over a long period develop early arthritis. If there is a rupture you may need to consider ligament or tendon repair surgery.
The typical ligaments that sustain injury are the anterior talar fibular ligament (ATFL), calcaneofibular ligament (CFL), posterior tibiofibular ligament (PTFL), spring and deltoid ligaments.
The common tendons are the Achilles, flexor hallucis longus, posterior tibial tendon and peroneal tendons.
These structures can be assessed in clinic and imaging such as ultrasound and MRI can identify if any are torn and ruptured.
If surgery is required you will need to use crutches until at least the sutures are removed in two weeks. After this time you will need to gradually increase your activities and the healing process can take up to twelve weeks.
