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Ankle Fracture According To Your Podiatric Healthcare Provider
The Basic Anatomy Of The Ankle Joint
The ankle joint comprises of 3 bones and several ligaments that attach to these bones and interconnect them, making the joint functionally stable. The 3 bones are:
The ankle is made up of 2 joints. Any one or both may be involved in bringing about an ankle fracture.
- The main ankle joint where the 3 bones — tibia, fibula and the talus — meet at a junction
- The Syndesmosis joint occurring between the tibia and fibula, held together in position by ligaments
What Is Called An Ankle Fracture?
Any type of break or crack occurring in one or more of the bones making up the ankle joint qualifies for an ankle fracture.
Fracture involving only 1 bone is classified as a simple fracture that may not produce any hindrance in your routine activities. A complex fracture is an outcome of several broken bones that cause the ankle joint to be displaced. A dislocated ankle joint is a painful and limiting force for your daily activities, restricting your movement for a few months.
The ankle fracture may further be complicated in the presence of damaged or ruptured ligament that hold together the joint strongly for its stability and robustness.
Nearly all age groups are affected by breakage at the ankle joint, especially youngsters following an active lifestyle, and sports personnel who are faced with frequent wear and tear issues.
Factors Leading To Ankle Fracture
- Sports Injury are a prime cause of ankle fractures occurring in athletes and sporting people rather too frequently, lying within all age brackets. Besides the regular wear and tear phenomenon this class of individuals is more prone to serious issues involving other structures in the foot as well. Being professionals they need instant supervision, treatment and guidance by a professional foot and ankle specialist.
- Road Accident is one of the major induced causes of a broken ankle that may involve automobile collision or being a pedestrian. The severity of the fracture can only be determined by a professional podiatric doctor who would prove your best helper and guide during these trying times.
- Awkward & Sudden Fall: A fall or tripping over that occurs in an awkward and sudden fashion often leads to abnormal twist of the ankle joint on either sides (medially or laterally). Relative to the extent of twisting force the injury may be complicated all the more with multiple fractures along with partially or fully ruptured ligament(s).
- Arthritic Condition of the joint that also includes osteoarthritis
The Signs & Symptoms Of Ankle Fracture
- Excruciating Pain following the injury almost immediately is the first sign your foot and ankle doctor would be hinted and alerted at. The pain is often unbearable being of high degree and doesn’t let you take a step further.
- Inability To Walk occurs hand-in-hand with the stinging pain associated with the fractured ankle whereby the affected is rendered almost unable to stand or walk further than the point of mishap.
- Swelling as a part of inflammation occurring at the wound site can often be disturbing when a special footwear size has to be arranged to accommodate the larger-than-life foot.
- Bruising may occur as a consequence of an accident or fall involving coming into powerful contact with sharp-edged or highly uneven surface. If external, bleeding would set in from the ruptured skin. In case of being internal, bleeding would be visible as a discolored skin due to internal blood accumulation and coagulation.
- Tenderness in the surrounding area of the injury is nearly a potent confirmation of the presence of a badly wounded ankle. The region specifically appears softer to touch than other close-by regions.
- Deformity of the ankle joint occurs in almost all severe mishaps whereby there is a dislocation or a fracture in the bone(s). This condition is often complicated and time-consuming in its treatment process.
The Diagnostic Process Of Ankle Fracture
Since an intense sprain arising in the ankle joint can often disguise the presence of an actual fracture, an experienced foot and ankle specialist would be able to distinguish between the two overlapping ankle issues by employing the latest diagnostic methodologies that include the following:
- A Thorough Medical History for careful decision-making
- A Detailed Physical Examination for general assessment and confirming the broken structure(s)
- Imaging Techniques developed to serve the very purpose of acquiring precision, accuracy and reliability that include:
- Stress Test
- CT Scans
- MRI Scans
The Treatment Methodologies Of Your Podiatric Specialist
The main goal of treatment of a broken ankle is to get its joint heal with a normal shape. Once the ankle is placed back together, the next step is to regain normal movement. The long-term goal of repairing a broken ankle is to decrease the chance of ankle arthritis in the future. Both conservative and surgical means of treatment are available at your podiatric physician’s disposal.
The Nonsurgical Treatment
The application of first aid presents an emergency treatment meant to ward off your pain and swelling issues temporarily. The full treatment can only be had at a dedicated foot and ankle clinic packed with all facilities and amenities required for a perfect, speedy recovery.
Treatment of ankle fractures noninvasively depends on the type and severity of the injury. As the first step, your foot and ankle healthcare provider would suggest you to follow the PRICE protocol which is the established method of administering first aid to the sufferer, described below:
- Protection of the wounded area from further injury
- Resting the bruised ankle to avert its additional damage by weight-bearing
- Ice application to ease off the pain and reduce swelling in the joint
- Compression of the ankle via softly wound crepe bandage for immobility
- Elevation of the ankle up to the chest level to reduce pain and swelling
Additional conservative treatment options include:
- Immobilization via protecting and restricting the ankle and foot in a cast or splint, allows the bone to heal. It is done under a certain set of conditions, i.e. only when a single bone is involved, there is no dislocation or misalignment and the ankle appears stable.
- Medications are usually prescribed by your podiatric surgeon in the form of pain-killers or NSAIDs to help relieve the pain and inflammation.
The Surgical Treatment
For operative procedure the required conditions are just converse, i.e. multiple fractures with torn or ruptured ligaments and other soft tissue-related injuries, partial or complete dislocation and an unstable ankle that is visibly deformed. Serious and complex ankle breakage matters do need a professional podiatric surgeon to carry on with the task of corrective surgery to resolve the more debilitating condition.
- Types Of Surgical Procedures
The various types of surgical procedures involved in correcting a broken ankle and its nearby structures are discussed below:
- Debridement is a type of ankle surgery used to relieve pain from osteoarthritis. This is a minimally invasive ankle surgery that works by removing or cleaning cartilage surrounding the joint of the ankle.
The surgeon uses a small instrument called an arthroscope, which makes incisions and has a camera to view the inside of the ankle.
- Ankle Fusion is an ankle surgery that is recommended for severe osteoarthritis, misalignment, infections or other serious problems. Ankle fusion may be provided for those who want to return to high impact activities or sports.
The surgeon places pins or plates inside the ankle joint to hold it together, so as it heals, it creates one bone. If the joint fails to fuse, the hardware may break.
- Ankle Replacement Or Arthroplasty is often used for patients who want to avoid high-impact sports and who have an arthritic condition or a prior trauma, such as a broken ankle.
The surgeon removes the damaged joint and replaces it with an artificial joint.
- Ankle Ligament Repair Procedures involve several types of repair surgeries which include shortening the stretched or torn ligaments, then attaching them to the bone with staples or screws.
- Ankle Arthroscopy makes use of a tiny camera and surgical micro-instruments that are placed through the skin into the joint to assess the extent of damage.
The surgeon, during the process, trims loose cartilage, shaves off bone spurs, and repairs stretched or torn ligaments.
- Scope Of Ankle Surgery
Ankle surgery is performed for several reasons, including:
- To Strengthen & Stabilize A Severe Ankle Fracture
- To Replace An Ankle Joint Destroyed By Osteoarthritis
- For Ankle Ligament Reconstruction
- To Reduce Swelling & Inflammation
- To Improve Flexibility In All Directions
The Recovery Time Period
The normal average recovery time needed for a completely healed ankle joint lies between 6 to 8 weeks during which your podiatric specialist would suggest you to keep your motion at minimum for least ankle suppression under your own weight. Doing conversely may well cause the fractured bones to slip and fail the surgery.
Ligaments and tendons usually require more time to heal up. Although most patients are able to resume their routine schedule within 4 to 5 months, a period of 2 years has been recorded for complete recovery against a fractured ankle.
Physiotherapy is essential to ring about speedy recuperation as a result of specifically crafted light exercises meant to provide strength to the atrophied muscle mass around the joint and to regain normal movements of the healed joint gradually until a time that a fully functional foot lets you perform normally.
The Potential Risks & Complications
The potential complications of ankle fracture surgery include:
- Bacterial Infection In The Wound
- Damage To Nerves & Blood Vessels
- Excessive Bleeding
- Blood Clot Formation
- A Bad Reaction To The Anesthesia
- Stiffness, Weakness & Arthritis In The Ankle Joint
- Delayed Wound Healing
Factors that elevate the risks of ankle fracture surgery include the following:
- Smoking Cigarette
- Usage Of Steroids In Any Form
- Diabetic Condition