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Ankle

There’s a good chance that while playing as a child or stepping on an uneven surface as an adult you sprained your ankle. Sometimes, it is an awkward moment when you lose your balance, but the pain quickly fades away and you go on your way. But the sprain could be more severe; your ankle might swell and it might hurt too much to stand on it. If it’s a severe sprain, you might have felt a “pop” when the injury happened.

A sprained ankle means one or more ligaments on the outer side of your ankle were stretched or torn. If it is not treated properly, you could have long-term problems.

You’re most likely to sprain your ankle when you have your toes on the ground and heel up (plantar flexion). This position puts your ankle’s ligaments under tension, making them vulnerable. A sudden force like landing on an uneven surface may turn your ankle inward (inversion). When this happens, one, two or three of your ligaments may be hurt.

Tell our doctor Dr T Sringari, what you were doing when you sprained your ankle. He will examine it and may want an X-ray to make sure no bones are broken. Depending on how many ligaments are injured, your sprain is classified as Grade I, II or III.

 

Treating your Sprained Ankle

Treating your sprained ankle properly may prevent chronic pain and instability. For a Grade I sprain, follow the R.I.C.E. guidelines:

  • Rest your ankle by not walking on it.
  • Ice it to keep the swelling down.
  • Compressive bandages immobilize and support your injury.
  • Elevate your ankle above your heart level for 48 hours.
  • The swelling usually goes down within a few days.

For a Grade II sprain, follow the R.I.C.E. guidelines and allow more time for healing. A doctor may immobilize or splint your sprained ankle.

A Grade III sprain puts you at risk for permanent ankle instability. Surgery may rarely be needed to repair the damage, especially in competitive athletes. For severe ankle sprains, your doctor may also consider treating you with a short leg cast for 2-3 weeks or a walking boot. People who sprain their ankle repeatedly may also need surgical repair to tighten their ligaments.

 

Recovering from your Sprained Ankle

Every ligament injury needs recovery time. Otherwise, your sprained ankle might not heal completely and you might re-injure it. All ankle sprains, from mild to severe, require three phases of recovery:

  • Phase I includes resting, protecting and reducing swelling of your injured ankle.
  • Phase II includes restoring your ankle’s flexibility, range of motion and strength.
  • Phase III includes gradually returning to straight-ahead activity and doing maintenance exercises, followed later by more cutting sports such as tennis, basketball of football.

Once you can stand on your ankle again, your doctor will prescribe exercise routines to strengthen your muscles and ligaments, and increase your flexibility, balance and coordination. Later, you may walk, jog and run figure eights with your ankle taped or in a supportive ankle brace.

It’s important to complete the rehabilitation program because it makes it less likely that you’ll hurt the same ankle again. If you don’t complete rehabilitation, you could suffer chronic pain, instability and arthritis in your ankle. If your ankle still hurts, it could mean that the sprained ligament (s) has not healed right, or that some other injury also happened.

To prevent future sprained ankles, pay attention to your body’s warning signs to slow down when you feel pain or fatigue, and stay in shape with good muscle balance, flexibility and strength in your soft tissues.

 

For Sprained Ankle Treatment in Gurgaon visit Polaris Hospital.

What is an ankle fracture?

A fracture is a partial or complete break in a bone. In the ankle, fractures involve the far or distal ends of the tibia, the fibula, or both bones. The tibia is the shinbone and is located on the inner, or medial, side of the leg. The fibula is located on the outer, or lateral, side of the leg. The distal ends of the tibia and fibula bones are also known as the medial and lateral malleoli, respectively.

Some distal tibia fractures can involve the rear or posterior part of the bone, which are also known as posterior malleolar fractures. Ankle fractures can range from the less serious avulsion injuries (small pieces of bone that have been pulled off) to severe, shattering-type breaks. Some fractures may also involve injuries to important ankle ligaments that keep the ankle in its normal position. Ankle fractures are commonly caused by the ankle twisting inward or outward.

What are the Fractured Ankle Symptoms ?

​One or all of these signs and symptoms may accompany an ankle fracture:

  • Pain at the site of the fracture, which can extend from the foot to the knee.
  • Swelling, which may occur along the length of the leg or be more localized at the ankle.
  • Blisters may occur over the fractured area. An orthopaedic foot and ankle surgeon should promptly treat these.
  • Bruising.
  • Decreased ability to walk. It is possible to walk or bear weight upon the ankle with less severe fractures. Never rely on walking as a test of whether the ankle is fractured.
  • Bones protruding through the skin. This condition is known as an open ankle fracture. These types of ankle fractures require immediate treatment to avoid problems like infection.

Most patients with ankle fractures are treated in an emergency room or a doctor’s office. An X-ray of the damaged ankle may be taken to determine what the fracture looks like, which bones are broken, how separated or displaced the bones are, and to find out the condition of the bone itself. The X-ray will help determine the proper course of treatment.

 

What are treatment options?

 

Elevation and Ice

Swelling is often seen after an ankle fracture. By limiting the amount of swelling, the pain from the ankle fracture can be decreased and further damage to the surrounding soft tissue may be prevented. Elevating the ankle and icing the affected area can help to limit swelling.

Splint  

A splint may need to be placed to support the broken ankle. The splint usually remains for several days. A splint allows for room to accommodate swelling. If the damaged ankle is not displaced, the splint may be applied immediately without moving the broken ankle. However, if the bones are displaced and/or the ankle joint is dislocated, a closed reduction is performed while the splint is placed. This treatment involves setting the tibia and/or fibula bones and ankle joint to improve the position and pain at the ankle. This treatment may require some type of anesthesia.

Rest/No Weight Bearing

Most patients require some period of rest with no weight being put upon the ankle. Crutches, walkers and wheelchairs allow patients to keep weight off of the ankle. Many factors can determine which is the best choice for an individual patient. The type of ankle fracture will determine when patients can start to stand and walk on their injured ankle. In many cases, a patient will not be able to place any weight on the ankle for several days, weeks or even months. This is a determination that must be made by an orthopaedic foot and ankle specialist.

Cast/Fracture Boot Immobilization 

Some ankle fractures can be treated without surgery. These are usually injuries where one bone is minimally displaced. Such fractures can be treated simply with a period of immobilization. Once the initial swelling improves over the first several days, either a cast or a fracture boot can be applied to the ankle to properly protect and immobilize it. Both a cast and a boot can provide adequate protection to the ankle. A cast cannot get wet or be removed without special tools. A boot can be removed for bathing and sleeping. The type of fracture and the physician’s judgment will determine the best type of immobilization.  The cast or boot is worn until the fracture is fully healed, which usually takes two to three months.

 

Surgery

Whether or not a patient requires surgery​ will largely depend on the appearance of the ankle joint on the X-ray and the specific type of fracture. Badly displaced fractures and fractures of both the tibia and fibula commonly need surgery.  Restoring alignment of the broken bone is essential to full recovery because ankle arthritis can occur if a fracture heals improperly. The best way to minimize the risk of arthritis is to restore the ankle to as close to normal as possible.

The surgical treatment is known as an open reduction and internal fixation or ORIF. An outer or lateral incision is made at the ankle if the fibula bone is broken. An inner or medial incision is made at the ankle if the distal tibia bone is broken. The injured bones are set properly through these incisions and kept in place with metal plates and screws. As the ankle heals after surgery, the joint is protected with restricted activity and a cast or fracture boot. The cast or boot is worn until the fracture is fully healed, which usually takes two to three months.

What happens during recovery?

Our orthopaedic surgeon will probably schedule additional X-rays while the bones heal, to make sure that changes or pressures on the ankle don’t cause the bones to shift.

Potential Complications

Usually there are few complications from a broken ankle, although there is a higher risk among diabetic patients and those who smoke. Your orthopaedic surgeon may prescribe a program of rehabilitation and strengthening. Range-of-motion exercises are important, but keeping weight off the ankle is just as important.

A child who breaks an ankle should be checked regularly for up to two years to make sure that growth proceeds properly without deformity or uneven leg length.

 

 

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