Broken Ankle

A broken ankle can significantly impact daily life, restricting mobility and independence. Tasks like walking, driving, and standing become challenging. A fractured ankle has the potential to impact daily life and activities, making knowledge of its symptoms, diagnosis, and treatment options essential for anyone at risk of such injuries. This comprehensive blog will explore the signs and symptoms of a broken ankle, delve into the common causes behind such injuries, and outline the steps for diagnosis. 

What is a Broken Ankle? 

A broken ankle, or ankle bone break, is a significant injury that demands immediate attention and care. This type of injury encompasses a range of fractures that can afflict the ankle, sometimes implicating multiple bones in the ankle joint. Therefore, understanding the importance of prompt and effective treatment becomes essential, as the ankle supports the body's weight and plays a pivotal role in movement. The recovery journey and outcomes significantly depend on the severity of the break, the accuracy of the diagnosis, and the effectiveness of the chosen treatment path. 

Signs and Symptoms 

• Immediate, throbbing pain in the ankle 
• Swelling in the ankle 
• Bruising or discolouration as blood and other fluids accumulate under the skin 
• Extremely tender to the touch 
• The ankle may appear deformed or out of its normal shape and alignment 
• Difficulty or pain with bearing weight 

Causes 

An ankle bone broken can occur due to various traumatic events that exert excessive force on the ankle joint, such as: 

• Twisting Injuries: It can happen when the ankle is forcefully twisted beyond its normal motion limits, such as during sports activities, falls, or missteps. 
• Impact Injuries: Impact injuries occur when a significant force is applied directly to the ankle, such as falling from a height or being struck by a heavy object. 
• Crush Injuries: Crush injuries can occur in situations like car accidents or when the ankle is trapped under a heavy object. 

Diagnosis

Diagnosing a broken ankle involves a combination of physical examination and imaging tests: 

• Physical Examination: The process begins with your doctor evaluating your ankle to check for points of tenderness and assess your range of motion. 

To confirm the ankle fracture, your doctor will likely recommend the following imaging tests: 

• X-rays: Most ankle fractures, except stress fractures, are visible on X-rays. 
• Bone scan: A bone scan can diagnose ankle fractures that don't appear on X-rays. 
• Computerized Tomography (CT): CT scans can reveal more detail about the injured bone and the surrounding soft tissues. 
• Magnetic Resonance Imaging (MRI): This imaging technique can identify fractures not seen on X-rays and provide insights into the condition of ligaments and bones. 

Treatment When Your Ankle is Broken

The broken ankle treatment depends on the severity and type of fracture, including: 

• Non-Surgical Treatment: Doctors may recommend a non-surgical approach for minor ankle fractures without significant displacement or misalignment. This method typically involves following the RICE protocol: 
  • Rest: Resting the injured ankle is crucial to allow healing. 
  • Ice: Applying ice packs to the injured area for 20 minutes at a time can help reduce swelling and inflammation. 
  • Compression: You may need to wear a cast or brace to immobilise the ankle and prevent further injury. 
  • Elevation: Keeping the injured ankle elevated above the level of your heart can also help minimise swelling. 
• Surgical Treatment: In more severe ankle fractures, doctors may perform ankle surgery for broken ankles to realign the fracture segments and repair any associated damage. Some common surgical procedures include: 
  • Ankle Fracture Fixation Surgery: In case of misalignment or displacement of the bones, your orthopaedic surgeon will reposition them and secure them using specialised hardware like plates, screws, or pins. 
  • Non-Union Ankle Fracture Surgery: In cases where a broken bone has failed to heal correctly (known as a non-union), surgery may be necessary to remove any infection, stabilise the fracture, or stimulate bone growth using a bone graft. 
  • Ankle Reduction Surgery: In case of misaligned fracture segments, your orthopaedic surgeon will reposition them into their correct alignment using specialised hardware like plates, screws, or pins. 

Risk Factors 

Several factors can increase your risk of sustaining a broken ankle fracture. These include: 

• Participating in high-impact sports 
• Using improper technique or sports equipment 
• Not warming up and stretching before an activity 
• Osteoporosis 
• Suddenly increasing activity level 
• Walking around a house with too much clutter or inadequate lighting may lead to falls and ankle injuries. 
• Conditions like diabetes, peripheral vascular disease, peripheral neuropathy, inflammatory joint diseases, obesity, and kidney diseases 
• Smoking 

Complications 

While broken ankles generally heal well with proper treatment, some potential complications may arise. These include: 

• Arthritis 
• Bone infection (Osteomyelitis) 
• Nerve or blood vessel damage 
• Delayed healing or non-union 

In rare cases, a broken ankle can cause compartment syndrome, a condition characterised by pain, swelling, and potential disability in the legs' muscles. 

When to See a Doctor 

Delaying treatment can lead to complications and improper healing. Here are some guidelines on when to seek medical help: 

Visit a hospital if: 

• The ankle pain is severe or worsening 
• A large amount of swelling or bruising that is increasing 
• Difficulty putting weight on the injured ankle 
• The ankle feels very stiff or is difficult to move 
• High fever or chills 
• You heard a crack or popping sound when the injury occurred 
• The ankle appears deformed or is at an odd angle 
• A feeling of numbness, tingling, or loss of sensation in the foot or ankle 
• The skin around the injury looks blue, grey or is cold to the touch 
• Open wound or protruding bone at the injury site 

Prevention

Preventing a broken ankle involves taking precautions and adopting healthy habits. The following are some effective strategies to reduce the risk of sustaining an ankle fracture: 

• Maintain Bone Health: Ensuring robust and healthy bones is crucial for injury prevention. Incorporate calcium and vitamin D-rich foods like dairy products, leafy greens, and fatty fish. 
• Exercise Regularly: Regular workout helps strengthen the ligaments and muscles that support the ankle joint, improving balance and coordination. 
• Wear Proper Footwear: Invest in well-fitting, supportive shoes designed for your specific activities and replace athletic shoes regularly. 
• Warm-up & Cool-down: Before engaging in physical activities, warm up with light stretches or a slow jog to prepare your muscles and joints. After exercise, cool down with gentle stretches to prevent muscle tightness and improve flexibility. 
• Gradually Increase Activity Levels: If you're starting a new exercise program or enhancing the intensity of your workouts, do so gradually over several weeks. 
• Cross-train and Vary Activities: Different activities can help build overall strength and prevent overuse injuries. To give your ankles a break, rotate high-impact activities with low-impact ones (swimming or cycling). 
• Be Mindful of Your Environment: Keep your living and working spaces free of clutter and ensure adequate lighting to prevent trips and falls. When engaging in outdoor activities, be cautious of uneven terrain, holes, or obstacles that could cause ankle injuries. 
• Use Protective Equipment: If you have a history of ankle injuries or participate in high-risk activities, consider using ankle braces or taping to provide additional support and stability. 

Conclusion 

Understanding broken ankles empowers us to navigate this challenging injury effectively. Each step plays a crucial role in recovery, from recognising symptoms to choosing appropriate treatments. Remember, swift medical attention can prevent complications and set the stage for optimal healing. By embracing preventative measures like regular exercise and proper footwear, we safeguard our ankles against future risks. Managing a broken ankle extends beyond immediate care-a journey of recovery, prevention, and resilience. With this knowledge, we're better equipped to face ankle injuries, ensuring a quicker return to our daily lives and cherished activities. 

FAQs 

1. Is a broken ankle serious? 

While the severity can vary, any fracture in the ankle joint requires prompt medical intervention and proper treatment to ensure accurate healing and prevent long-term complications. 

2. How long does a broken ankle take to heal? 

The healing time for a broken ankle can vary and depends on the type and severity of the fracture. Simple fractures may take approximately 6 to 12 weeks to heal, while more complex fractures can take several months to recover fully. 

3. Can I still walk on a broken ankle? 

Walking on a broken or fractured ankle is generally not recommended, as doing so can cause further injury and impede the healing process. 

4. How painful is a broken ankle? 

A broken ankle is typically associated with immediate, throbbing pain that can be severe and intense. The pain may be associated with swelling, bruising, and tenderness in the affected area. 

5. Can a broken ankle heal naturally? 

While some minor hairline fractures may heal naturally with proper immobilization and rest, most broken ankles require medical treatment to ensure correct alignment and healing. 

Dr. Shubham Chandrakant Padmawar

MBBS, MS
Ganga CARE Hospital Limited, Nagpur

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