Ankle fracture with displacement and without: treatment and rehabilitation after injury
Methods of treatment and rehabilitation after ankle fracture with displacement and without
This injury is very common in trauma and is approximately twenty percent of all injuries in the musculoskeletal system.
A fracture of the ankle are divided into fractures with displacement and without displacement. Injury to the ankle it is impossible to distinguish with the naked eye.
His symptoms are mild, and most doctors usually have to resort to x-rays.
One of the main mistakes affected is the self.
Many do not realize the severity of the injury, considering it a minor injury or sprain. Self-medication in such cases, usually leads to serious consequences.
The cause of trauma
Causes of ankle injuries typically are divided into two categories:
- First, the fracture took place as a result of injury. In this case, fracture becomes the result of the sharp turning of the foot or povertyline. This povertyline can be external and internal. Happen well as complex fractures with involvement of other bones or fracture associated with the dislocation. Also, in rare cases, an ankle fracture can be a result of the accented beat.
- Second: injury as a result of age-related changes in the body. It is widely known that with age, worse absorb calcium, and bones become more fragile. The elderly are more common fractures. Not rare and fractures of the ankle. In addition, it should be noted that in old age bones grow worse, which sometimes entails a lengthy rehabilitation period after the trauma.
Of course, these reasons do not exist separately from each other and often go hand in hand.
Although it is established that in older people a fracture can happen almost «out of the blue» situation, this is not a friendly.
Classification of fractures
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Classification of ankle injuries is very extensive and involves a large number of options. We highlight the main and most common:
The type of damage
- Outdoor (with a bleeding wound and fragments of bone);
- Indoor (without breakout the soft tissues).
The presence of bias
- Accompanied by an offset;
- Without displacement.
At the location of the injury
- In the outer ankle (distal part of fibula bones);
- The inner ankle (distal part of the tibia).
In the direction of the fracture
- Pronational (povertyline ankle to the outside);
- Supination (povertyline ankle inside);
- Rotary (povertyline rotated).
Combined (complex) fractures
- With dislocation;
- With involvement of other bones.
The most common is a fracture of the lateral malleolus without displacement.
What are the symptoms we can diagnose a fracture in the ankle? The symptoms of trauma will, inevitably, differ depending on the varieties of fracture.
Let’s look at the symptoms, depending on the type of injury:
Symptoms of a closed fracture of the outer ankle without any displacement
The main symptom of this injury is swelling of the ankle. Complicated mobility. The victim usually can bend the ankle, but the ankle twist to the side, sometimes associated with severe pain.
Patients will manifest radiatsionnyi symptom: when pressing on the middle of the ankle, the pain will occur at the site of fracture.
Known cases where patients with fractures of the outer ankle some time walking by on the injured leg, knowing «normal injury».
This neglect of the injury may be detrimental to the process of further treatment and delay the rehabilitation.
Symptoms of a fracture in the inner ankle without displacement
This injury is also characterized by the presence of swelling in the area of the ankle joint, but in this case, the swelling will be localized on the inside of the ankle.
Thus, the ankle will be smooth, without is usually eye-catching bone. When movement in the ankle joint, the patient will feel sharp pain.
Known cases when with such trauma, patients a few days stepped on a sore foot resting on the heel or edge of foot.
During the feeling, the pain occurs on the inner side of the foot.
As in the fracture of the outer ankle, this type of injury is difficult diagnosed without an x-ray machine.
Therefore, patients are often a long time trying to be treated independently, without referring to the doctors, which negatively affects the rehabilitation process and its success.
The signs of fracture of the ankle with displacement
Clinic this injury is similar to that described above, however, the symptoms will be more acute.
So the pain becomes stronger and the patient will not be able to move. Swelling at the site of fracture will be much more severe and is often accompanied by bleeding. Fragments of bones during movement can dig into soft tissue, causing extreme pain.
Not rare in this case pain and shock, sometimes accompanied by loss of consciousness.
This fracture is fraught with complications, because the bones are shifted relative to their natural position, causing the sharp edges of the soft tissue.
An open fracture in his ankle
Trauma is accompanied by rupture of the soft tissues and bleeding. In the area of the ankle are major blood vessels at the breaking of which the patient may lose a lot of blood, so in this case it is extremely important to quickly stop the bleeding.
In some cases, the bone fragments can bulge outwards, shocking the victim. The victim can endure pain and psychological shock due to blood loss, so it is particularly important that there was people willing to give first aid.
The doctor examines the patient’s foot and is interested in the situation of injury. Clarifies the symptoms and physical mobility of the foot. In most cases, the doctor resorts to x-ray diagnostics and computer tomography.
The definition of the exact diagnosis, with the General symptoms of swelling and bruising in the ankle, very complicated.
Thus, only x-ray can give an accurate picture of the injury: the presence of fracture, displacement of fragments or bone tissue.
The picture is taken in the lateral and anterior-posterior.
Trauma to the external ankle, in the picture marked with the following changes:
- When pronational fracture in the back, barely visible line of fracture passes through the oblique line on the level of the tibiofibular syndesmosis. On the side picture the fault line can be traced more clearly and has an upward direction.
- When supination fracture, back in the picture, the visible transverse line a ankle joint or below. On the side picture, the line is not seen clearly, is on top of the talus.
Trauma in the inner ankle, in the picture marked with the following changes:
- In a transverse fracture, in the picture behind the horizontal line of the fault intersects the base of the ankle at the level of the slit ankle or below. On the side the picture will be barely noticeable line on the block of the talus, but may be not noticeable.
- When an oblique fracture in the back, clearly visible oblique or vertical fault line. On the side picture, the line of fracture on the tibia epimetaphysis.
Therapeutic measures for injuries of this kind
First of all, you should help the patient make minimally painful body position.
In no case do not try to put in place the inside-out joint.
Shoes should be removed if possible and the patient does not cause acute pain. After that, it is enough to put under the limb some support, for example, a branch or folded clothing.
You should immobilize the injured leg by wrapping a pillow or folded several times a clothing and tie tightly with a rope. Next you need to call the ambulance or independently to deliver the victim to the clinic.
Treatment of a fracture of the ankle without displacement and with displacement is different.
In the first case, is used to treat a conservative way. Broken ankle bandage is applied over the bandage.
You should not unnecessarily protract the leg, so as not to impede normal blood flow. Bandaging should be done from the top down, when reaching fingers to expand in the opposite direction. On leg put into a cast for six weeks.
Time in plaster is determined individually, as age increases the time of bone healing. After the plaster is removed to produce a control x-ray on the basis of which offer the rehabilitation.
If the injury is combined with displacement of bone, treat conservative method only in the case of exact restoration of the natural position of the bones.
Usually the patient is doing local anesthesia and in half an hour, set bones and fragments in place. Then applied plaster. In some cases, when you re-bias the leg in the immobilizer.
Surgical treatment is carried out under the condition of open fracture.
In this case, it is crucial to quickly deliver the victim to a doctor. The operation involves reduction of the bones and stitching torn soft tissue and blood vessels. Further, the treatment coincides with the treatment for a closed fracture.
In all cases, as a rule prescribe anti-inflammatory drugs and drugs that promote the splicing of bone tissue.
Rehabilitation after injury
The rehabilitation period starts with the removal of the plaster. To improve circulation prescribed electromagnetic therapy.
Rehabilitation after ankle fracture without displacement or with displacement is divided into two stages:
- Immobilization (about a month);
- Functional recovery of the joint (1 to 3 months).
In the first stage, patients recommend therapeutic exercises designed to improve muscle tone.
In the second phase, the emphasis is on exercises designed to restore functional mobility and muscle tone of legs.
To prevent fracture of the ankle is recommended:
- Without preparation not to practice traumatic sports;
- To include in your diet foods rich in CA and vitamin D;
- To do gymnastics;
- To avoid inactivity, and to lead an active lifestyle.