Ankle Fractures
Ankle Fracture Causes and Symptoms
Many different motions or incidents can cause an ankle fracture to occur. Some of the most common ways include twisting or rotating your ankle, tripping or falling, and impact during an accident. When you fracture your ankle it is common for you to experience immediate severe pain, swelling, bruising, an inability to put any weight on the injured foot and sometimes, a noticeable deformity becomes present.
Ankle Anatomy
The ankle joint consists of three bones known as the tibia, fibula, and talus. The tibia and fibula consist of the medial, posterior, and lateral malleolus. There are two different joints involved when an ankle fracture occurs: the ankle joint, where the three bones of the ankle meet; or the syndesmosis joint, the joint between the tibia and fibula that is held together with ligaments. The ankle joint is important in three vital movements: plantar flexion, moving the foot downward away from body; dorsiflexion, backward bending of the foot; and inversion turning the foot from side to side and; eversion movements, turning the foot side to side inward and outward. The ankle joint also works at absorbing shock as the heel strikes the ground when walking and/or running.
Dr. Bryant Castelein, DPM – Podiatry Specialist
Advanced Imaging for Ankle Fractures
- X-Ray: An x-ray is the most common imaging method for ankle fractures and can show if the bone is broken or if there are gaps between the bones, also known as displacement. Brighton Foot and Ankle has an in-office x-ray machine, which allows Dr. Castelein to quickly diagnose and treat the injury.
- CT Scan: This form of imaging is used to help treat more advanced ankle fractures. CT creates a cross-section image of the ankle providing great detail and assisting Dr. Castelein in the surgical planning process.
Types of Ankle Fractures
Fibular Fracture:
There are three different areas where the fibula can fracture. The fibula fracture either breaks below the ankle joint, at the ankle joint, or above the ankle joint. Fibular fractures represent the majority of ankle fractures. Lower energy trauma typically results in only the fibula being fractured whereas higher energy trauma can result in the fibula being fractured as well as other areas of the ankle. Imaging is necessary to properly diagnose a fracture as well as to monitor the healing process during the recovery period and to ensure continued ankle stability.
Bimalleolar Fracture:
This type of fracture occurs when the tibia and fibula bones are broken. Usually, a bimalleolar fracture means two different bones are broken and the ankle joint becomes unstable, requiring surgical treatment to restore stability and best reduce future arthritis.
Trimalleolar Fracture:
In a trimalleolar fracture, three different areas of the ankle joint are broken. This fracture builds upon the bimalleolar fracture and includes the back side of the ankle joint. This is an unstable injury and can involve related dislocations. A trimalleolar fracture typically results from high energy trauma. Surgical treatment is needed unless there are significant health risks.
Ankle Fracture Conservative and Surgical Treatment
Conservatively, Dr. Castelein will have patients follow the RICE Protocol: Rest, Ice, Compression, and Elevation. RICE requires immobilizing the ankle by placing it into a fracture boot or cast until the bones have healed. Typically, this treatment requires patients to be non-weight bearing for an average of six weeks to allow for the bone to heal.
In some cases, surgery is needed to stabilize and restore the ankle joint shape. A displaced fracture is generally unstable and surgery is usually recommended to reduce the risk of future arthritis, ankle instability and pain. Dr. Castelein is a board-certified podiatric surgeon and is able to expertly perform the appropriate surgical procedure based on the fracture type, severity, and patient-relevant details. He approaches each surgery with injury specific procedures and uses advanced methods such as minimally invasive incisions, flexible implants, and ultrasound to increase bone healing. Dr. Castelein’s goal of surgery is to restore the ankle’s natural movement while allowing for an early return to weight-bearing status and pre-injury activity.
