Ankle fracture, its symptoms and treatment
Ankle fracture is a fairly common injury of the lower extremities. The ankle, or as it is commonly called, ankle, designed by nature in such a way that it has a large amplitude flexion-extension. Paradoxically, it is this feature, allowing us to comfortably walk on uneven surfaces, makes the joint vulnerable to injuries, sprains and fractures. And if this does not happen after every step of the way, only because nature provided the relief mechanism surrounding the ankle of the massive apparatus of ligaments and muscles. But it happens that this mechanism fails.
Types and factors of fractures of the ankle
In fact, the only cause of injury to the ankle is acting on the joint excessively. But the factors causing this surplus, quite a lot:
- excessive body weight;
- uncomfortable, tight shoes;
- physical fatigue;
- landing from a great height on the legs;
- a severe blow to the ankle;
- the effects of disease in which bones become brittle (arthrosis, bone tuberculosis, osteomyelitis, and others).
Why is ankle fracture? Rigidly fixed on the foot affects other force or external, blow to the ankle, or, more often, the strength of the ongoing movement of their own upper leg, and then povertyline foot: the outside of the foot, inside or back. And if acting on the joint force powerful enough, the safety mechanism of ligaments and tendons can not withstand the load. A fracture occurs. When such injury break one or both ankles, i.e., the projecting lower part of bones of leg: fibula and tibia.
Today in medicine is to distinguish two kinds of fractures of the ankle: indoor and outdoor. The most common of which is closed, in which the broken bone stays within the surrounding soft tissue without violating its integrity. With an open fracture of the ankle broken bone breaks the soft tissue and exits.
Distinguish fracture of the ankle joint without and with offset. When a displaced fracture usually occurs not only fractures, but also deformity of the joint.
A closed fracture without displacement is the easiest version of fracture, but at the same time and the most insidious. The fact that it is often the symptoms are very similar to the symptoms of severe injury. Ignorance, these two injuries are easy to confuse, and as for bruises, very painful, not always in a hurry to see the doctor, a time when the treatment of the injured joint effectively, is lost.
The type of fracture depends on the capacity of acting on ankle joint power. And this is the type of fracture depends on the time required for the treatment and rehabilitation of the patient. This period may vary from one to four months and even more.
The main symptoms of the injured ankle
For each type of fracture characterized by their symptoms. However, there are General for all kinds of symptom: severe pain. In closed form fracture – a dull, aching, open – sharp, cutting. In most cases on the injured leg because of the pain it is impossible to tread. After a broken ankle, regardless of the type of injury characterized by rapid onset of hematoma, soft tissue swelling around the joint. At the slightest attempt to touch the damaged joint pain becomes sharp, almost unbearable.
Differences in symptomatology of fractures is not as apparent. In a closed fracture the pain symptoms are not too identified. So after such a fracture, if there is no offset, the victim, fixing the foot splint or tight fixing bandage, maybe even some time to walk with a broken ankle. But if injuries with displacement, then walk due to severe pain is impossible.
About the an open fracture to pain through a broken ankle increases the pain from the tears in a place of soft tissue injuries. Despite the fact that this type of injury is considered to be heavier than a closed fracture, but it is diagnosed accurately. However, the victim this is no easier, and the treatment itself is much longer.
The most dangerous in traumatology is considered a displaced fracture. In this case, in addition to the early diagnosis of trauma, also required to correctly determine the degree of deformation of the joint. The options here are many: injury or loss of the joint capsule, loss of bone shards, etc. given the nature of the fracture before you begin treatment, you first need to return to the place of the shifted part. Therefore, the treatment and rehabilitation after injury with shift lasts on average 3-4 weeks longer than usual.
A preliminary diagnosis can be made on the basis of external symptoms, but for final diagnosis, be sure to conduct radiography. Moreover, to have an accurate idea of the nature of the fracture, such a study should be carried out from two points: the front of the knee and on the side.
If there is suspected fracture with displacement, the surgeon must send the victim for a CT scan to see three-dimensional image of the damaged joint.
Healing of the fracture
In the treatment of fractures of the ankle there is one axiom: the sooner you get qualified help, the more effective the treatment. A long delay in the diagnosis of trauma is fraught with inflammation of the damaged joint, which often leads to chronic arthritis, arthrosis and other unpleasant diseases. Rehabilitation in this case lasts much longer and is not always completely successful.
Therefore, when the slightest suspicion of an ankle fracture don’t need to try not to get up, but even moving the injured foot. First aid should be aimed not at reducing pain, as is usually done at dislocations or sprains, and for fixing damaged feet stationary. To do this, to the damaged joint from two sides privinchivayutsya wooden tires.
If there is bleeding, is usual companion of open injuries need to stop or at least minimize. If bleeding is mild, it is usually enough to bandage the wound with a clean bandage. If it is too intense or bandage the wound is impossible because of her protruding bones, open wounds will be bandaged with a tourniquet.
Treatment depends on the type of injury. With an open fracture before the trauma task is not just to collect the ankle to mend broken bones and to make it so that the victim could subsequently okay to walk, run and even dance. Treatment of open fracture is always surgical intervention, because you have first right to lay down the joint, and then to sew up the damaged soft tissue. For the closed forms of injury, surgical intervention is required very rarely – only in the case of complex displacement. In the vast majority of cases, treatment of a closed fracture is an outpatient method.
Common types of such injuries that the damaged joint is necessarily a plaster bandage.
How many have affected to wear it depends largely on the complexity of the injury and the age of the victim. If there is no offset, this period basically fit in 8-10 weeks, injuries, dislocation and open fractures within 4 months. However, there are cases so complex that the patient has to wear a plaster cast for six months or more.
Rehabilitation and recovery
To restore normal operation in the affected joint rehabilitation. Rehabilitation of broken ankle is a complex of measures, including:
- Physical therapy (physiotherapy);
- physical therapy;
- revitalising massages;
- reducing a warm bath.
The main task of the exercise – develop the injured joint, keeping it working tone delivered from the physical exertion of muscle and repair damaged blood circulation. Therefore, experienced doctors include elements of physical therapy is actually for 3-4 days after getting a cast. It is recommended to actively move the toes of the injured leg. You can also bend and straighten the injured leg at the knee and raise it up and lower down the bed. The nature and intensity of the movements is determined by the physician, and to be zealous in physical therapy, and furthermore make changes in the set of exercises – it is impossible.
To start to restore mobility of the legs should be careful not to Paranagua her. The first days after the liberation from the plaster bandage, it is better not to rest your foot on a hard surface and perform movements in warm water. Start walking using two crutches, getting on the leg, but only lightly touching its surface. Gradually increase the load of physical therapy, it introduced new, more challenging exercises: circular movements with the leg, then flexion-extension of the foot. This is recommended to roll the foot a small ball or a tennis ball.
In the future, physical therapy exercises for added resistance. Along with physical therapy during this period, recovery is usually prescribed restorative massage and swimming in the pool. In the final period of rehabilitation the main task is the restoration of full health of the injured extremity. During this period, physical therapy included long walks over rough terrain, exercise on ascent-descent flights of stairs, and all this is done without the use of crutches.
A well-conducted rehabilitation is a guarantee that after recovery problems when moving an injured joint is. But for those who have suffered such an injury, you should always be careful, because often there are cases of re-fracture.