Definition & Overview
The term “fracture” is a medical condition that refers to a partial or complete break in a bone. The bones of the feet are important because they bear the weight of the body so that people can walk, run, jump and basically, move. With a foot fracture, it means that at least one of the 26 bones in the foot is broken, the most common of which is an ankle fracture.
An ankle fracture is a type of foot injury where one or more bones of the ankle joint are broken. Ankle fractures may be simple breaks like undetected tiny cracks in the bones that are sometimes mistaken for ankle sprains because they share similar symptoms. Some fractures may be severe, shattering breaks that force patients off their feet for a few months or more. Some ankle fractures involve not just the shattering of the bones but also the tearing of ankle ligaments that keep the ankle joint stable.
Cause of Condition
Foot or ankle fractures may result from both acute and chronic conditions such as the following:
* Twisting or rotating the ankle – This is one most common causes and usually happens by accident.
* Falls – Landing suddenly and heavily on foot or ankle is also a major cause of foot or ankle fractures. The sudden movement of putting all the weight on the feet and ankles, either from jumping from a great height or when stopping a fall, can put too much pressure that can lead to broken bones.
* Overuse – When the bones begin to weaken from continued stress or repetitive pressure on them, ankle fractures become inevitable.
* Car accidents – The impact or crushing injury arising from car accidents may cause foot or ankle fractures. The feet and ankles are most often pinned down or crushed when the car crumples around the body. These types of conditions usually require surgical repair. * Impact from a heavy weight – Aside from the crushing impact of a car, the mere act of a heavy object falling onto the foot or ankle can break the bone. It may be a direct impact or it can be at an angle but the weight and force of the blow will definitely affect the severity of the breaking of the bone.
The danger of misdiagnosing an ankle fracture as an ankle sprain may be avoided if the following symptoms are given full attention:
* Definitive pain at the site of the fracture and sometimes extending from the foot to the knee. The pain increases when you try to put weight on it and decreases when you rest it.
* With pain comes swelling particularly in the area around the ankle and possibly extending along the length of the leg.
* Bruising of the foot or ankle becomes obvious * Mobility is severely affected because of the inability to bear weight on the affected foot or ankle. Although minor fractures can allow you to walk, it is still best not to force your foot to bear the weight. * The ankle is obviously deformed, severely dislocated or protruding from the skin.
Who to See and Types of Treatments Available
Patients who experience the symptoms listed above should head straight to the doctor’s office or the emergency room to get prompt treatment. The first step is evaluating whether or not there are actual breaks in the bone to warrant an ankle fracture diagnosis. To do this, the doctor will review the patient’s medical history and inquire as to how the injury occurred.
Depending on the results of the initial tests, an x-ray of the damaged ankle may also be ordered. This will show the broken bones, how displaced they are and in what condition they are in. Other imaging tests, such as a CT scan and an MRI may also be recommended to assess the extent of the injury and to determine whether the ankle ligaments are also affected.
Treatments of ankle fractures will depend on which bones are broken and the severity of the condition. Below are the treatment methods for foot or ankle fractures:
* R.I.C.E. Protocol – R.I.C.E., which stands for Rest, Ice, Compression and Elevation, is considered the first aid for ankle fractures and sprains. It involves:
* Rest – staying off the injured ankle so that means no walking or putting any weight on it for a pre-determined period
* Ice – Applying an ice pack for at least 20 minutes on the injured area soothes the tissues and muscles and reduces the swelling and pain
* Compression – Wrapping the injured ankle in an elastic bandage reduces the swelling and keeps the ankle stable.
* Elevation – Keeping the ankle slightly elevated keeps the swelling to a minimum.
* Splint and reduction – If the ankle is not severely damaged but has been slightly displaced, the doctor will manipulate the bones into their proper place before using a splint to allow the bones to heal naturally. A muscle relaxant, pain reliever or sedative may be required for this procedure.
* Cast/fracture boot immobilization – Another method to heal the bones naturally is by putting in a cast or a fracture boot. A cast is the most common immobilizing technique for more serious injuries. A temporary brace or boot may be an alternative for a minor foot fractures.
* Surgery – There are times when there is no other recourse but to undergo surgical procedures to correct the ankle fracture. Some procedures require the application of screws and metal plates to keep the bones in place while they heal.
References * Managing Your Ankle Fracture. In: Ferri FF, ed. Ferri's Clinical Advisor 2015. 1st ed. Philadelphia, PA: Mosby Elsevier; 2014:appendix V. * Ankle fractures. In: Eiff MP, Hatch RL, eds. Fracture Management for Primary Care. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 13.