Broken Ankle Pain Getting Worse

Broken Ankle Diagnosis Treatment Surgery & Recovery

Kevin D. Martin, DO, FAAOS,

Orthopedic Foot and Ankle SurgeonAssociate Professor of Surgery

About the author Dr. Martin specializes in orthopaedic surgery of the foot and ankle. In addition to his practice Dr. Martin serves as committee member of the American Orthopaedic Foot and Ankle Society and is a regular contributor to multiple medical journals including Foot and Ankle International.

A broken ankle is one of the most common lower leg injuries. Also called an ankle fracture, it can be a very painful injury and needs to be seen by a medical professional as soon as possible because it may need treatment to heal properly. Walking on a broken ankle can make the injury worse, so if in doubt get it checked out.

The ankle joint is comprised of three different bones, and any one of them can break. Treatment options vary based on the type and severity of the fracture, and recovery typically takes six to 10 weeks.

Is The Ankle Sprained Or Broken

A thorough evaluation by an Orthopedic Specialist in Foot and Ankle such as Dr. Miller will identify the nature of the injury. Immediately following the injury, it is reasonable to assess the ankle with weight bearing. If there is no pain with walking, an ankle fracture is highly unlikely. Soreness with walking but the ability to walk normally suggests a contusion or sprain of the ankle. However, if you cannot stand on the ankle, an evaluation is warranted to rule out a broken ankle or ankle fracture.

Swelling is another sign of injury. If the swelling comes on gradually and is mild, the injury is likely a sprain or less severe. More immediate and significant swelling indicates a bony injury and possible fracture. When severe fractures occur, blistering of the skin is not uncommon. The blisters emanate from excessive swelling in the soft tissues following a severe fracture. Sometimes the ankle is dislocated with this amount of swelling. Immediate medical attention is required in these circumstances to reduce the ankle. Once severe swelling or blistering sets in, this can take weeks until the initial swelling resolves. In many cases these changes can delay surgery on the ankle.

My Ankle Is Sprainedbut Is It Fractured Too

Ankle sprains are the most common injury in the United States. Sometimes they go hand-in-hand with a fracture. So how can you tell if your ankle is sprained and fractured? Dr. Tom Miller talks to orthopedic specialist Dr. Alexej Barg about the signs of an ankle fracture.

Dr. Miller: You sprained your ankle, could you have a fracture and what to do about it? I’m Dr. Tom Miller in here with Scope Radio.

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Crutches For A Broken Ankle

Close up of man walking with broken ankle on crutches and cast

If your doctor decides that crutches are necessary to aid the healing of your fractured ankle, there are three main types to choose from. Each type has different features, and you should choose the ones that are most appropriate for your lifestyle or needs.

The first are traditional hand-held crutches, which allow you to avoiding putting weight on your injured ankle. These crutches are more affordable, easier to set aside when needed and are relatively lightweight. However, they have limitations, as they require the use of both hands in order to use them correctly. These crutches can sometimes e challenge for those who dont possess a lot of upper body strength and can tire you out easily.

The second option is a knee scooter, which allows for partial elevation of your ankle, while allowing for the use of your hands when needed. The scooter also doesnt require much upper body strength and is more useful for those who will be upright for long periods of time. Some limitations to this type are that it is bulky, hard to move over uneven surfaces and requires both hands when moving.

Each type is different and you should choose according to the type that fits your needs best.

How To Tell The Difference Between An Ankle Sprain And A Fracture

Did you know ankle injuries are one of the most common bone and joint injuries for athletes, weekend warriors, and those of us just walking through different daily activities? Many people assume its easy to tell the difference between a fractured bone and a joint sprain, but sprains and fractures share many symptoms making it hard to know whats causing your pain.

At Arlington/Mansfield Foot & Ankle Centers, our experienced team of providers help patients in Arlington and Mansfield, Texas, with effective diagnoses and care for ankle sprains and ankle fractures. Read on to learn how to tell the difference between ankle sprains and fractures and what you can do about both!

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General Information About Pain After A Fracture

Pain is the bodys natural response when a bone breaks. Both the fracture and any injuries to the body tissue near the fracture site can produce pain. Soft tissue refer to the muscles, ligaments, nerves, tendons and blood vessels, joint cartilage, etc. that surround the bone. When the soft tissue around the fracture is injured the result can be pain, swelling, bruising and redness.

Can An Ankle Sprain Cause A Broken Ankle

A sprained ankle happens when you stretch or damage your ankle ligaments through overuse or injury. Think of a piece of elastic thats been through one too many cycles in the washer and dryer. You can have an ankle sprain because you have a broken ankle, but a sprained ankle won’t cause your ankle to break.

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Activities Of Daily Living

Participants described their difficulty or inability to complete their activities of daily living, such as personal care, household tasks, work and leisure activities. When discussing personal care and washing and dressing, many people spoke of finding new routines and adapting to new ways of doing things. Individuals discussed these in relation to their walking aids and weight-bearing status, stating that these factors meant that the process of washing and dressing took much longer. Those who received the functional brace spoke of the benefit of removing the brace for washing. Those who received a plaster cast discussed the need to use a cast cover for washing. Some female participants spoke of the frustration of not being able to shave their leg due to the irremovable cast.

Household tasks were severely restricted by participants injuries and many spoke of these in the context of their walking aids, as they did not have hands free to carry things. Many spoke of relying on others for completion of essential tasks such as meal preparation and grocery shopping. Some spoke of adaption in doing things such as housework by getting on their hands and knees to complete tasks. Many people described how others took on the majority of the housework and caring for any dependents. Some people found a source of frustration in the standards of the other person completing the housework, which did not match their own personal standards.

How To Treat A Sprained Or Strained Foot

As with fractures, you should also use the RICE method to treat a fractured foot before you see a doctor. If you have a mild sprain or strain, the RICE method should provide sufficient treatment to let your injury heal. It is still a good idea to see a doctor about a mild sprain or strain in case your injury requires further care.

If your sprain or strain is moderate to severe, your doctor will immobilize your foot or ankle with a cast, brace or splint. The most severe foot sprains and strains require surgery. Whatever extra treatments your doctor provides, continue to use the RICE method to aid healing.

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Ankle Sprain Treatment And Recovery In South Texas

Improper treatment for an ankle sprain or fracture, returning to your activities too soon, or repeatedly injuring your ankle can delay your recovery or worse, create new problems. Prevent your condition from worsening by consulting an ankle specialist immediately after you get injured or experience symptoms.

Visit the Podiatry Group of South Texas if you are experiencing symptoms from an ankle injury. We have 14 different locations in Southern Texas for your convenience. Our friendly experts provide top-notch medical care and will ensure that you understand your treatment process.

How Do Ankle Fractures Happen

Most people break their ankles after taking a direct hit on their ankle. They might fall hard, or be struck by something that caused their ankle to break. Here are some ways that an ankle fracture can happen:

• Being in a motor vehicle accident.
• Playing sports, particularly sports where you are likely to be hit on your ankle or you make sudden moves that twist your ankle.
• Falling from a significant height.
• Tripping and falling.
• Taking a misstep and rolling” your ankle.

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What Happens Before Orif Surgery

You’ll receive general anesthesia. To prepare for general anesthesia, you should:

• Avoid food and drinks for eight hours before you go to the hospital unless directed.
• If you smoke, quit smoking at least two weeks before your surgery to improve your heart and lung health. Even quitting for one day before your surgery helps your heart and lungs.
• Stop taking herbal supplements and anti-inflammatory drugs for one to two weeks before the procedure as directed by your healthcare provider.
• Stop taking Viagra® or other medications for erectile dysfunction for at least 24 hours before the procedure.
• If you take certain blood pressure medications, talk to your healthcare provider about taking your medication with a sip of water.

What Happens During Orif Surgery For An Ankle Fracture

• Your surgeon makes incisions to open your ankle joint to access your broken ankle bones.
• They line up your ankle’s broken pieces. This is called reduction.
• Your surgeon uses tools such as metal plates, screws or wires to connect your ankle’s broken pieces. This is calledinternal fixation.
• They close the incision.
• Your surgeon will put your ankle in a cast or brace.

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What Does A Diagnosis Involve

Its important to get medical attention if you think you may have broken your ankle, or if you have severe pain, swelling, or bruising after injuring your ankle.

Your doctor or healthcare professional will carefully examine your ankle, foot, and lower part of your leg. Theyll also check for tenderness and move your foot to get an idea of how well you can move your ankle joint.

If your injury is more severe, your doctor may recommend one or more of the following imaging tests to help them accurately diagnose your injury:

Even though the symptoms of a sprained and broken ankle are similar, the treatments are quite different.

First Aid For Sprained Ankles

Below is a list of recommendations for urgent treatment of sprained ankles.

• Cease all activity immediately.
• Try to rest the sprained ankle.
• Place ice on the ankle for 20 minutes intervals every 2 hours Do not place it directly onto the skin. Separate with a damp towel.
• Bandage or compress the sprained ankle firmly. The wrapping should extend from below to above the ankle.
• Wherever possible, try to elevate the sprained ankle above the height of the heart.
• Stay away from alcohol, heat, massaging, and running on the injured ankle for the initial 72 hours, as this can increase swelling.
• Try painkillers such as paracetamol, also try ibuprofen gel, spray or mousse for the swelling.

As long as the swelling of the sprained ankle subsides and there is no pain while walking, the individual can begin exercising to regain and build strength and flexibility.

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Other Severe Ankle Pain Causes

Other conditions can eventually lead to severe ankle pain.

• Ankle impingement: This involves a bony growth at the front of the ankle bone where it meets the shinbone. It restricts the ankle’s range of motion and causes pain.
• Metabolic disorders: This may involve a buildup of mineral crystals within the joints, often in the big toe or the ankle. This causes intense pain and some swelling. The buildup may be caused by either uric acid crystals in people with gout or calcium pyrophosphate dihydrate crystals in those with pseudogout.

Anatomy Of The Ankle Joint

The ankle joint is composed of the tibia, fibula and talus bones. The talus connects your leg to your foot.

Skeletal anatomy of the ankle

Ligaments connect bone to bone to provide stability of the joints. They are commonly injured in the case of ankle sprains. They can also be injured in connection with ankle fractures. When ligaments are torn and associated with an ankle fracture, this damage can render the ankle unstable. The deltoid ligament is found on the inner part of the ankle and provides the majority of the stability of the ankle. If the deltoid ligament is torn in association with a fracture, the ankle is generally unstable.

In the ankle joint or any joint in the body, two or more bones move relative to one another. There is a cushion or lining between the bones, which is called cartilage. Thinning or damage to this cushion can lead to arthritis or inflammation in the joint.

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How Are Ankle Fractures Treated

Ankle fracture treatment depends on factors such as the number of ankle bones broken. Not all broken ankles require surgery, but all broken ankles require some level of care to heal.

You probably won’t need surgery if you have a stress fracture. You might need a brace or cast to support your ankle while it heals. More serious ankle fractures require reduction or surgery.

Reduction is when healthcare providers manipulate your ankle to line up the ends of your broken bones. Youll receive local anesthesia to numb your ankle.

Strengths And Limitations Of This Study

• Use of well-recognised reporting standards for purposes of transparency.
• Duplicate data analysis for consistency.
• Use of purposive sampling to account for key demographic variables.
• Participants were recruited from a clinical trial which restricted the timing of data collection.
• Individuals who declined to take part in the trial or the interview study may have had different experiences of recovery compared with those who agreed to participate.

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Acute Pain Immediately After A Fracture

Immediately or soon after a fracture occurs, most people will experience what is called acute pain. Medication to reduce this type of pain is often prescribed during this stage. Acute pain will decrease with time.

In order for a broken bone to heal, it may need a cast, a brace, a splint, surgery or any combination of the above. Whatever method is used to treat your broken bone, the key is to reduce or immobilize the fracture for several weeks so that the bone can set or heal.

• Reduce means to bring the broken ends of the bone as close together as possible to speed up the healing process. Sometimes, this requires surgery.
• Immobilize means to prevent the broken ends of the bone from moving apart again so the fracture can set or heal. A cast, a brace, a splint or surgery may be used to immobilize the area around the fracture.
• A broken bone in the back is managed by a combination of rest and the correct method of controlled movement.

It is important that you follow the instructions you are given by your doctor in terms of rest and movement. You may be asked to avoid certain movements so that you do not make the injury worse.

When Do I Get An X

Dr. Miller: You probably need an X-ray or should get an X-ray and seek attention for that. If you can’t weight bear immediately after, that doesn’t necessarily mean that you have a fracture, but if that persists beyond a day or 12 hours to a day, then you probably need an X-ray. Even if it’s a mild sprain and you’re still struggling with pain after a couple of weeks, then you need to seek attention for that and get radiographs to make sure you haven’t had a fracture.

Dr. Barg: Yes, absolutely. Another specific situation in this patient group is, for example, again, 95 percent of this group do heal without any restriction in the long term. However, those five percent, they still have, for example, four, six months after the initial injury, they still have some pain in the ankle or especially the instability feeling. Specifically, when the patient tries to walk on an uneven surface. Those patients need to see the doctor to see whether they need to be treated or not for ankle instability.

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Additional Causes For Severe Ankle Pain

Injuries to the ankle due to various fractures, sprains, or Achilles tendon ruptures can cause severe ankle pain. Ankle injuries are is among the most common reasons people visit the emergency room.

• Avulsion fracture: A ligament or tendon tears away from its attachment on the bone, taking a fragment of bone with it.
• Fibula fracture: The fibula is the smaller of the two bones in the lower leg. A break just above the ankle can cause severe ankle pain.
• Stress fracture: This is a crack or severe bruising in the small bones of the ankle, due to overuse and/or weakening from a loss of minerals.