Ankle Fracture

Ankle fracture is a condition where one or more ankle bones break. The condition can be caused after an injury to the ankle bones, the tibia, fibula and talus. The injury might result from twisting by misstep/fall or any accident. Ankle fracture is one of the most common causes of ankle pain, and the treatment usually depends upon the location and seriousness of the fracture. The fractures can range from a small tears to skin-piercing breaks.

Types of ankle fractures

There are the following types of ankle fractures:-

1. Lateral malleolus fractures: It is found on the outside of the ankle (fibula). This area is under most pressure during activities like walking, pivoting, and running.
2. Medial malleolus fracture: It is rare and it occurs inside your foot(tibia).
3. Bimalleolar ankle fracture: it occurs when both the inside and outside of the ankle are affected.

You injure an ankle joint when you put it under more stress than its bones can handle. The most commonly observed causes for an ankle fracture are:

1. Motor vehicle accidents: Sudden, heavy impacts might lead to a broken ankle during an accident.
2. Misstep: You might break your ankle if you put your foot forward awkwardly. In such cases, your ankle might twist or roll to the sides.
3. Falls: Losing your balance and falling can put extreme pressure on your ankle. Walking on uneven floors or even wearing ill-fitting shoes can affect your balance.
4. Overuse: Repetitive force to the ankle might lead to a stress fracture, i.e., a small tear in the bone. It is very common in runners.
5. Trauma: Crush injury and fracture can occur when a lot of force is applied to the ankle. A big object falling on the foot or heavy machinery running over the ankle might cause this.
6. Heavy impact: The force of a jump or fall can lead to a broken ankle, even from a low height.

The factors that increase the chances of an ankle fracture are:

1. Involvement in any heavy impact sports.
2. Using improper techniques, ill-fitted shoes or faulty sports equipment.
3. Elevating your activity level all of a sudden.
4. Walking around cluttered or uneven surfaces.
5. Conditions like osteoporosis. 

An ankle fracture cannot be confirmed without proper diagnosis. However, a few common signs that might indicate ankle fracture are:

1. Sudden and extreme ankle pain
2. Swelling
3. Bruising
4. Difficulty in walking
5. You cannot bear pressure on the ankle
6. Tenderness 
7. Foot appears dislocated if the bone pierces the skin, bleeding can be noticed

For diagnosing an ankle fracture, your physician will initially conduct a physical examination. The physician will look for the location of the swelling and tenderness to determine the condition's cause. The physician will also move your foot in various directions during the physical examination.

Later, based on the physical examination, the physician might recommend some tests, such as:

1. X-Rays: Most of the fractures can be visualised on X-ray. However, tiny fissures might not get diagnosed via X-Ray until the break begins healing.
2. Bone scan: This test can diagnose conditions X-Rays cannot visualise, such as tiny fissures. A minute quantity of radioactive material is injected into the veins in this test. The material has a greater affinity for damaged bones, and therefore, damaged areas are highlighted by bright spots during the diagnosis.
3. CT scan: During the CT-Scan, X-Rays are taken from various angles and are combined to form a cross-sectional image of internal conditions..
4. MRI: It employs radio waves and an effective magnetic field to form detailed images of the ligaments that hold up the ankle. MRI identifies ligaments and bones that cannot be seen on X-Rays.
5. Stress test: It determines the need for surgery. During a stress test, the physician exerts some pressure on the ankle and takes an X-Ray. If the joints open up, it indicates the need for surgery.

Treatment of a broken ankle can be surgical or non-surgical based upon the severity and location of the injury. However, the physician may initially prescribe an over-the-counter pain killer for instant relief.

Non-surgical treatment:

1. Walking boot, cast, or splint: In case of stress fracture (tiny fissure), your doctor might recommend non-surgical treatment options such as a brace or cast to support your ankle while it heals.
2. Ice: The physician might advise you to apply ice to reduce pain and swelling just after the injury. You must wrap the ice in a towel before applying it to the skin.
3. Crutches: These aid you in walking without exerting any pressure on the ankle. 
4. Reduction: If the bone has been displaced from its position, the physician might need to move it back in place physically. This process is known as closed reduction. To control the pain and discomfort, you might be under the influence of general anaesthesia.
5. Immobilisation: The broken bone must be immobilised so that healing can take place. It might require a special boot or cast.

The various benefits associated with treatment of an ankle fracture includes:

1. It provides relief from pain, swelling and discomfort.
2. It prevents worsening of the symptoms and complications such as arthritis or nerve damage.
3. It enables the individual to walk normally

An ankle fracture is a very common condition, and its treatment is very effective. However, ignoring the condition might worsen the symptoms and some uncommon complications such as arthritis, bone infection, compartment syndrome or nerve damage.