Foot and Ankle Trauma

Foot and Ankle Anatomy

The foot and ankle work together to provide balance, stability, movement, and propulsion to the human body. Its complex anatomy consists of 26 bones, 33 joints, muscles, tendons, ligaments, blood vessels, nerves, and soft tissues.

Foot and Ankle Trauma

Foot and ankle trauma refers to injuries that most commonly occur during sports, exercise or any other physical activity. Trauma may be a result of accidents, poor training practices or use of improper gear. Injuries may also be caused when an individual is not medically fit or because of insufficient warm-up and stretching exercises.

An ankle injury is the most common sports-related injury; but you don't necessarily have to be an athlete to injure your ankle, as walking on uneven surface can result in a twisting injury. The most common ankle injuries include sprains, strains, and fractures.

What are Ankle Sprains?

A sprain is the stretching or tearing of ligaments, which connect adjacent bones in a joint and provide stability to the joint. 

Causes of Ankle Sprains

An ankle sprain is a common injury and occurs when you 

• Fall or suddenly twist the ankle joint 
• Land your foot in an awkward position after a jump 
• participate in sports 
• Jump or run on a surface that is irregular

Symptoms of Ankle Sprains

Ankle sprains can cause pain, swelling, tenderness, bruising, stiffness, numbness in the toes and inability to walk or bear weight on the ankle. 

Diagnosis of Ankle Sprains

The diagnosis of an ankle sprain is usually made by reviewing the history of the injury and performing a physical examination of the ankle. X-rays of your ankle may be ordered to determine the extent of the injury. 

Treatments of Ankle Sprains

The most common treatment recommended for ankle sprains is rest, ice, compression and elevation (RICE).

• Rest: You should not move or use the injured ankle in order to reduce pain and prevent further damage. Crutches may be prescribed to help in walking. 
• Ice: An ice-pack should be applied over the injured area up to 3 days after the injury for 20-minute sessions, periodically. You can use a cold pack or crushed ice wrapped in a towel. Ice packs help to reduce swelling and relieve pain. Never place ice directly over the skin.
• Compression: Compression of the injured area helps to reduce swelling and bruising. This is usually accomplished by using an elastic wrap for a few days to weeks after the injury. 
• Elevation: Elevate the ankle part above your heart level to reduce swelling. 

Your doctor may also suggest a brace or splint to reduce motion of the ankle. Anti-inflammatory pain medications may be prescribed to help reduce pain and control inflammation. Avoid pivoting and twisting movements for 2 to 3 weeks. 

Prevention of Ankle Sprains

To prevent further sprains or recurrence of injury, you may need to wear a semi-rigid ankle brace while exercising, and special wraps and high-top tennis shoes for support. An ankle exercise program will also help to prevent recurrence of injury by making the ankles strong and flexible.

What is an Ankle Fracture?

An ankle fracture is a break in one or more bones that make up the ankle joint. Sometimes, ligaments may also be damaged. 

Causes of Ankle Fractures

Ankle fractures are most often caused by motor vehicle accidents, rolling or twisting of the ankle, and by tripping or falling. Sports such as basketball, football, soccer, and skiing increase your risk of fracturing your ankle. 

Symptoms of Ankle Fractures

The common symptoms of an ankle fracture include: 

• Pain and swelling around the ankle 
• Bruising 
• Tenderness 
• Inability to walk on the leg 
• Deformity if the ankle is dislocated

Diagnosis of Ankle Fractures

Following an ankle injury, it is important to have the ankle evaluated by your doctor for proper diagnosis and treatment. Diagnosis is made based on the history of injury and physical examination of the ankle. In addition, your doctor may order X-ray(s) of the ankle to determine the extent of the injury.

Treatments of Ankle Fractures

The treatment for ankle fractures varies with the type and severity of the injury. The common method of treatment is adequate rest, ice application, elevation of the injured leg and medications to reduce swelling and pain. A short leg cast or a brace may be applied over the fractured ankle to provide support. If there is severe injury, excessive swelling or severe pain, you should seek immediate medical treatment.

Some ankle fractures are treated with a splint, which is placed on the ankle for a few days until the swelling subsides. Once the swelling decreases, a cast may be placed on the ankle to hold the broken bones in place. Surgery may be needed to realign the bones before placing the splint. During surgery, your doctor may place metal screws, plates, or rods to hold the broken bones intact until healing happens. In some cases, crutches may be prescribed to prevent weight-bearing on the ankle.