Causes and risk factors
The common causes of ankle fracture are falls, road traffic accident, sports injury, overuse of bones. Disease conditions that predispose to broken ankle are osteoporosis, rickets, Osteomalacia, diabetes, rheumatoid arthritis where there is decreased bone density. People involved in activities like dancing, sports like basketball, football, running, marching are at high risk for broken ankle.
Clinical presentation
Clinical presentation of a broken ankle involves severe excruciating pain which is worse by slight movement, unable to move the ankle joint, swelling, tenderness, deformity in the broken ankle. Any movement of ankle is impossible and painful. Broken ankle can be of various types. Various kinds of fracture are – stress, undisplaced, displaced, comminuted, and compound fracture. A stress fracture presents as tiny cracks in the bone. It is caused due to overuse of bones. Pathological fractures are stress fractures like those seen in infection, Osteomalacia, osteoporosis, Undisplaced is a hairline fracture where there is little damage to surrounding tissue along with fracture. Displaced fracture is one in which bone is broken apart, moves away from its normal alignment. Comminuted fracture consists of bone broken into several pieces with or without displaced fragments. In compound fracture, the bone makes a breakthrough through muscles and skin, exposing the inner structures and broken bone.
Investigation
Medical history by the patient and Clinical examination by the orthopaedic doctor helps in diagnosis. X ray of the ankle joint is recommended which confirms the diagnosis. Imaging studies such as CT scan and MRI is useful for further evaluation.
Treatment
Treatment depends upon the type of fracture. Principles of the treatment involves immobilisation [by applying plaster cast, or traction], reduction [alignment of the separated broken bone ends] which can be open or closed, internal fixation [fixing the broken bone with help of implants such as screws, plates or rods] and rehabilitation. Stress and undisplaced fractures require only immobilisation whereas displaced, comminuted and compound fractures need open reduction and internal fixation [ORIF]. Supportive care such as physiotherapy is given to prevent further complications and improve the movement post surgery. Oral medications such as analgesics, NSAIDs are required.
Other Modes of treatment
The other modes of treatment can also be effective in treating broken ankle. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating broken ankle.
