Ankle
A "delicate" region
The ankle (tarsal tibia joint) is the joint region that connects the leg with the foot. It is stabilized by an effective ligament complex consisting of two ligaments that connect the tibia to the fibula, three lateral ligaments and the deltoid ligament.
In most cases the ankle fracture also involves the surrounding anatomical structures such as the numerous ligaments that stabilize it.
Causes
The injury is frequently caused by an exaggerated internal or external rotation of the sole of the foot and the forefoot. This condition can occur during accidents or be caused by severe trauma such as a landing broken down on the foot after a jump. Also for this reason it is recommended to take the utmost care in choosing sports shoes.
When we talk about an ankle fracture we generally mean a rupture of the distal part of the tibia (medial malleolus) or the distal part of the fibula (lateral malleolus). The fractures of the talus (the third bone that forms the articular complex) are in fact rather rare.
Symptoms
Symptoms of ankle fracture include local pain that is accentuated when the foot is under load, swelling and joint deformity. Precisely this last aspect, which is not always present, distinguishes the fracture from distortion. A simple radiograph is however able to highlight any skeletal lesion, which is often difficult to diagnose with simple physical examination.
Treatment
In the event of an ankle fracture it is good to immediately apply ice to the affected area, perform a compression bandage and immobilize the limb in the position in which it is located. This precaution is absolutely necessary to mitigate the pain and minimize the risk of further injury.
Often the treatment of ankle fracture requires surgery as the joint stability of the region can be seriously compromised by the trauma. The operation will aim to reposition the fractured bone in its physiological position. In this way the risk of arthrosis and chronic instability will be removed, rather frequent complications in this type of injury.
Recovery
If the doctor does not register obvious dislocations, he may decide to opt for conservative treatment by applying a brace or a chalky boot that will be maintained for 4-8 weeks. There are also special walking boots that limit the movements of the ankle under load, allowing a faster return to walking.
Recovery times after trauma are quite long and generally between three and four months. At the end of the immobilization period, proprioceptive exercises are performed combined with a work of mobilization and muscular reinforcement (lifting of the heel or calf, eversion and inversion of the feet, flexion of the foot with elastic bands, etc.). The immobilization in fact causes muscular hypotrophy and limitation of mobility, physical abilities that must be reacquired through scrupulous rehabilitation exercises. These exercises are essential to determine the success of the therapeutic program. The syndromes of inadequate rehabilitation are in fact quite frequent in the sports field and are associated with an increased risk of recurrences (sprains) and secondary complications (arthrosis).
After this first phase, the motor re-education course is rather similar to that planned for ankle sprain; see: rehabilitation of ankle sprain.
