Examples include isolated lateral malleolar fractures without deltoid sprain and some nondisplaced medial malleolar fractures. Simpler ankle fractures can be treated with early weight-bearing in a protective boot. More severe injuries may require hospitalization and either definitive surgery or a temporary surgery (external fixator) to hold the fractured ankle in place until swelling goes down. You may be sent home with crutches or some other form of assistive device to help keep weight off your ankle. If surgery is needed, it is commonly done within 5 to 10 days, but may be delayed up to 3 weeks in some cases if your ankle is too swollen. After reduction and splint application, your healthcare provider will explain if he or she thinks surgery is needed, and will most likely refer you to an orthopaedic surgeon for evaluation and further treatment. A stress x-ray is depicted in Figure 3B, and shows instability when compared to the image in Figure 3A. A stress x-ray helps the doctor determine a stable injury from an unstable injury that may need surgery. If the ankle is not dislocated and it is not obvious if the fracture is stable or not, a stress x-ray may be needed. Reduction is usually done after pain medications have been given, and these can include oral, intravenous, or local pain medications. If the ankle is dislocated, you may need a “reduction,” which means the doctor will manipulate the foot and ankle back in to position with his or her hands, and then apply a splint or boot. After this initial exam, x-rays are usually performed to help define the bony injury and some form of splint may be applied. Most often, the emergency room doctor will examine your foot and ankle for sensation, blood flow, and your ability to move your toes. Initial TreatmentĪnkle fractures are typically very painful and obvious if there is a dislocation (ankle joint out of place) or an open wound. You will need to talk to you doctor about your specific injury to get details on which type of ankle fracture you may have and if surgery is needed. As instability worsens, surgery is needed. Stable fractures can sometimes be treated in a cast or boot. This could mean a plate and screws, just screws, a nail, or just suture.įigure 6: A) Fracture of fibula only, B) fracture of fibula and tibia, C) Fracture of fibula and tibia (2 parts). When a lateral malleolus fracture is accompanied by a sprain of the ligament on the inside of the ankle (the deltoid ligament), your injury may be unstable and may require surgery. Lateral malleolus fractures are often stable and can be treated without surgery. It is called a lateral (outside of the ankle) malleolus fracture and is depicted in Figure 5.
The most common malleolus fracture happens at the fibula. The bony parts of the fibula and tibia are called malleoli (singular = malleolus). Because there are so many bony parts and ligaments, sometimes only 1 or 2 parts are injured, although many parts can be injured. Ankle fractures most often occur from a simple twist and fall, as can happen on a wet floor, a grassy hill, on stairs, or off a curb. Mechanism and EpidemiologyĪnkle fractures occur in people of all ages and are among the most common injuries treated by an orthopaedic surgeon.
Left lateral malleolus fracture skin#
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