The ankle is a common location for breaks in children. The ankle joint is made up of three bones: the tibia (shin bone), the fibula (smaller bone on the outside of the leg), and the talus (bone beneath the shin bone). The talus is rarely broken in children, whereas the tibia and fibula are frequently injured. A fall or severe twist may lead to a fracture in one or more of these three bones. It is also possible that the ligaments that support the bones of the ankle may be injured in a fall or other accident. The objective in diagnosing and treating a fractured ankle is to restore comfort and structural integrity.
Ankle Fracture Symptoms
The first and primary indication of an ankle fracture is noticeable pain occurring after a fall or other injury. The ankle may feel tender to the touch, and incapable of supporting weight as it could before the injury. A short time after an ankle fracture, swelling and bruising may be noticed. Severe fractures may present obvious physical deformity.
Ankle Fracture Treatment
In order to determine the appropriate treatment plan for an ankle fracture, one or more diagnostic tests may be performed. This may include:
- X-rays. This basic imaging test is commonly performed to observe the position and condition of the bones in the ankle. An x-ray will show us whether there is a clear break, and the extent of that injury. We may also be able to observe space in between the affected bones, as well as the number of areas in the bone or bones that have been broken. Sometimes, x-rays are conducted when slight pressure is placed on the ankle. This is referred to as a stress test.
- CT scan, or computed tomography. This diagnostic screening may provide greater detail of the ankle bones and joint, including cartilage, ligaments, and other soft tissue.
- MRI, or magnetic resonance imaging, may be performed to closely observe the ligaments and other softer structures around the injured bones and joint.
- Both the tibia and fibula have growth plates at the end near the ankle joint. In many cases, the growth plate is injured during the break. If the growth plate is involved and there is a question as to its alignment, your doctor may order a special test called a CT scan to better assess this.
Each ankle fracture is treated appropriately based on the location and extent of broken bones. When a fracture has occurred but the ankle is stable, meaning it can hold a bit of weight, proposed treatment may include a boot or cast. Wearing a boot or a cast usually coincides with a recommendation to rest the injured body part.
Some ankle fractures do not occur in a uniform fashion; bones are broken in a way that disrupts alignment. In such instances, bones will need to be realigned. This may involve manual repositioning, performed under sedation, or it may involve surgical realignment under general anesthesia in an operating room. Surgical correction of a fracture may also involve the placement of pins and/or plates. Again, this depends on the extensiveness of the injury and also the age of the patient.
When realignment is achieved, a cast is then placed over the ankle and calf to keep the area intact as bones heal over several weeks.
When surgery is necessary, treatment risks include adverse reaction to sedation and post-surgical infection. These risks are kept to a minimal through meticulous surgical protocols. Other risks include poor bone healing and poor scarring.
Recovery from an ankle fracture is different for every person and is based on the severity of the injury and involvement of joint structures, ligaments, and other soft tissues. The process of bone regeneration and healing is at least 6 weeks. During this time, periodic x-rays may be taken to assess the progression of healing. It is important to also note that initial recovery is related to bone healing only. Many patients need at least a short course of rehabilitation in the form of physical therapy in order to regain strength and flexibility in the injured area.
Schedule a Consultation
We are here to help you overcome your ankle injury with personal care from a seasoned orthopedic team. To learn more about ankle injury treatment or to schedule an appointment, please call 973-942-1315