What to do if you twist your ankle

Possible consequences of dislocation

As you know, in the ankle joint the bones of the lower leg are connected to the foot, representing the joint that is the most mobile, but at the same time fragile, and therefore the most vulnerable.
The bones that form the joint are small in size, but at the same time they form a complex system, which is subject to powerful pressure from the weight of the entire body. This pressure increases when a person walks faster, runs, or simply moves actively, for example, while dancing or quickly climbing stairs. And the ligaments act as a shock absorber in this fragile system: they are the ones that experience the maximum stress and most often suffer when the leg is twisted. What to do if you twist your ankle? Understand that a real injury has been received, and it requires treatment. Most often, victims are given one of the following diagnoses:

Sprain of the ligaments, which is expressed in their slight damage. This creates tiny tears. It is because of them that for some time (until complete healing) pain is felt in the injured area at the slightest movement.
A tear when the connective tissue is severely damaged. At the moment of injury, a click is heard. Then, when interviewed, the patient usually says that he twisted his leg with a crunch. The pain in this case is much stronger than with a sprain.
Dislocation or fracture. In the first case, the patient is found to have a displaced ankle. In the second case, you need to understand that even a small crack in the bone is already a fracture that requires rigid fixation for several weeks. At the moment when such damage occurs, a crunching sound is heard and the person feels severe pain. In this state, it is impossible to step on the injured leg.

The first of these diagnoses is the most common. When a ligament is sprained, the ankle swells and causes pain when walking. Bruises sometimes form at the site of injury, and the skin may become red or swollen. The leg may turn blue either immediately after a person twists it, or even after 2-3 days if there was a deep hemorrhage.

Dislocation

The first place in prevalence is occupied by traumatic dislocation of the shoulder, followed by dislocations of the fingers and elbow joint. Dislocations of the patella and hip joint are somewhat less common.

Traumatic shoulder dislocation

The high incidence of pathology is due to the structural features of the joint (the head of the humerus is in contact with the glenoid cavity for a short distance and is mainly supported by muscles, ligaments and a special soft tissue formation - the labrum), significant loads and a large range of movements in the joint. When damaged, acute pain occurs and there is a feeling that the shoulder is out of place. The shoulder joint looks unnatural: the head of the humerus is not visible, in its place a smoothed surface with a pointed upper edge is visible. The shoulder looks drooping. The patient's arm is usually pressed against the body.

Depending on the direction of displacement of the head, three types of dislocations of the shoulder joint are distinguished: anterior, posterior and inferior. Anterior dislocation is the most common (according to various sources, it occurs in 80-95% of cases). The head moves forward and ends up either under the coracoid process of the scapula (in this case, a subcoracoid dislocation occurs) or under the collarbone (subclavian dislocation). Typically, anterior dislocations are accompanied by minor damage to the labrum (the cartilage cushion that is a continuation of the glenoid cavity of the scapula and helps hold the head of the humerus in the joint). Posterior dislocation occurs infrequently (less than 20-5% of cases) and is accompanied by significant damage to the labrum. Inferior dislocation occurs very rarely. With such damage, the head of the shoulder “goes” down, and the arm is in a raised position until the moment of reduction.

To confirm the diagnosis, an x-ray of the shoulder joint is performed. CT of the shoulder joint and MRI of the shoulder joint are usually not required, with the exception of suspected severe injuries to soft tissue structures and fracture-dislocations. A slight disturbance of the blood supply and slight numbness of the limb are usually caused by compression of the neurovascular bundles and spontaneously disappear after the dislocation is reduced. Severe sensory disturbances may indicate nerve damage and are an indication for consultation with a neurosurgeon.

Reduction of fresh dislocations is usually performed in the emergency room under local anesthesia. A stale dislocation and an unsuccessful first attempt at reduction are indications for reduction under general anesthesia. Usually the Dzhanelidze method is used, less often the Kocher method. After reduction, the arm is fixed for three weeks. During this period, UHF is prescribed to reduce inflammation and exercise therapy (movement of the hand and wrist joint). Then immobilization is stopped, and exercises to develop the elbow and shoulder joints are gradually added to the exercise therapy complex. It should be remembered that the healing of the joint capsule takes time. Unauthorized removal of the bandage too early (even in the absence of pain) can lead to the formation of a habitual dislocation.

Habitual shoulder dislocation

Usually occurs after untreated acute traumatic dislocation. Predisposing factors are muscle weakness, increased extensibility of the capsule, a weakly concave scapula and a large spherical head of the humerus. Habitual shoulder dislocation is accompanied by less intense pain and can occur even with minor impacts. The frequency of repeated dislocations varies greatly - from 1-2 times a year to several times a month. The cause of development is the failure of the joint capsule. Surgical treatment is required. The indication for surgery is 2-3 or more dislocations within a year.

Traumatic dislocations of the phalanges of the fingers

Most often they develop when the tip of the finger is struck with force applied in the proximal direction. There is a sharp pain and noticeable visible deformation of the finger in the joint area. Movement is impossible. Increasing swelling is noted. To confirm the diagnosis, an x-ray of the hand is performed. Reduction is carried out on an outpatient basis, under local anesthesia. Then a plaster cast is applied and UHF is prescribed.

Traumatic dislocation of the elbow joint

The cause of injury is a fall on an outstretched arm or a blow to a bent arm. In the first case, a posterior dislocation occurs, in the second - anterior. The damage is accompanied by severe pain and significant swelling of the soft tissues. Severe deformation is detected in the elbow area; movements are impossible. The radial pulse is weakened, and numbness is often observed. In case of posterior dislocations, the head of the radial bone is palpated from the front, in case of anterior dislocations - from the back.

A distinctive feature of elbow dislocations is their combination with fractures of the ulna and radius, as well as damage to nerves and blood vessels. To confirm the diagnosis, an x-ray of the elbow joint is performed. According to indications, consultations with a neurosurgeon and a vascular surgeon are prescribed. Treatment is carried out in a hospital setting. Treatment tactics depend on the characteristics of the injury. In most cases, closed reduction is performed. If it is impossible to reduce the dislocation, align or hold bone fragments (in case of fracture-dislocations), surgery is performed.

Traumatic dislocation of the patella

The injury occurs due to a fall or blow to the knee during contraction of the quadriceps muscle. Lateral dislocations of the patella develop more often (the patella moves inward or outward). Less common are torsion (the patella rotates around a vertical axis) and horizontal (the patella rotates around a horizontal axis and is embedded between the articular surfaces of the bones that form the knee joint) dislocations. The damage is accompanied by severe pain. Deformation occurs and increasing swelling appears. The knee is slightly bent, movement is impossible. Upon palpation, a displaced patella is determined. Hemarthrosis is often observed.

The diagnosis is made based on characteristic symptoms and X-ray data of the knee joint. Reduction is usually not difficult and is performed under local anesthesia. Spontaneous reduction is also possible. For hemarthrosis, joint puncture is performed. After restoring the natural anatomical position of the patella, a splint is applied to the leg for 4-6 weeks. UHF, massage and exercise therapy are prescribed.

Traumatic hip dislocation

Occurs as a result of indirect trauma, usually from road accidents and falls from a height. Depending on the location of the femoral head, it can be anterior or posterior. A hip dislocation is manifested by severe pain, swelling, deformation of the affected area, forced positioning of the limb and shortening of the hip. Movement is impossible. To clarify the diagnosis, an x-ray of the hip joint is performed. Reduction is performed under general anesthesia in a hospital setting. Then skeletal traction is applied for 3-4 weeks, physiotherapy and exercise therapy are prescribed.

Congenital dislocations

The most common is congenital hip dislocation. It occurs as a result of underdevelopment of the femoral head and glenoid cavity. More often observed in girls. Identified immediately after birth. In infants, it manifests itself as limited abduction of the limb, shortening of the limb and asymmetry of skin folds. Subsequently, lameness occurs, and with bilateral dislocation, a duck's gait occurs. The diagnosis is confirmed by radiography, CT scan of the hip joint and MRI of the hip joint. Treatment begins in the first months of life. Special plaster casts and splints are used. If conservative treatment is ineffective, surgery is recommended before reaching 5 years of age.

The second most common condition is congenital dislocation of the patella. Compared to hip dislocation, it is a fairly rare anomaly. It may be isolated or combined with other malformations of the lower extremities. More often observed in boys. It manifests itself as instability when walking, rapid fatigue and limitation of movements in the joint. X-rays of the knee joint indicate underdevelopment and displacement of the patella. The dislocation is corrected surgically by moving the patellar tendon.

If treatment is not carried out, progressive pathological changes develop in the joint, which is in a state of congenital dislocation, and severe arthrosis occurs, accompanied by increased deformation of the limb, impaired support, and decreased or loss of ability to work. Therefore, all children suspected of having such a pathology should be under the supervision of pediatric orthopedists and receive timely and adequate treatment.

Procedure for an ankle injury

The first thing you need to do if you twist your ankle badly is to concentrate on your own feelings, listen to yourself. If everything is in order, the pain goes away on its own within 20–30 seconds. After the condition has returned to normal, you can continue moving.

What to do if you twist your ankle, but it hurts a lot, and there is no relief? Continue observation. If a limb aches, it needs rest for at least one hour. If, after twisting your leg, you feel severe pain when touched, bruising or swelling occurs, it is advisable to contact a medical facility. All of these could be signs of serious problems. What other symptoms of a sprained leg indicate that a doctor’s help is needed:

atypical joint mobility;
ankle instability, when the foot involuntarily changes its position when running or walking;
visible bone deformation;
persistence of pain during the first day;
inability to stand on the injured limb even several days after the incident;
ankle swelling;
the appearance of bumps;
loss of sensation in the foot (complete or partial, when, for example, the fingers or at least one of them go numb).

The traumatologist collects anamnesis, performs a visual examination and palpation. If this is not enough to clarify the diagnosis, the doctor will refer you for an X-ray, CT scan or MRI. Additional studies should exclude more complex injuries: fractures, dislocations. Self-treatment, much less realignment of a joint or bone, is unacceptable.

Treatment of a dislocated finger

Treatment tactics for a dislocated finger are determined individually. To select effective methods of therapy, the specialist uses data from the examination, anamnesis and examination. If the patient seeks help on time, the risk of complications after a dislocation is minimal. The doctor provides the necessary assistance and sends the patient home.

The main task of the traumatologist when treating a dislocated finger is to reduce the joint and fix it in the anatomically correct position. This will lead to rapid restoration of damaged tissue and return the finger to its previous shape. Maintaining complete immobility of the damaged joint is ensured by effective immobilization using a plaster cast or a special orthosis.

Dislocation of fingers is accompanied by severe pain. Immediately after the patient contacts, specialists use high-quality anesthesia, which ensures loss of sensitivity and restoration of the patient’s normal well-being. After anesthesia, diagnostic measures are carried out, the purpose of which is to assess the nature of the injury and identify hidden damage, as well as make professional prognoses for the future.

Reduction of the finger takes place under local anesthesia. The patient does not feel pain and is conscious. After the joint has been reduced, a control X-ray examination is performed to evaluate the quality of the work done. If there is serious damage to the ligamentous apparatus or it is impossible to perform closed reduction, surgical treatment is required. The sooner you seek help from a traumatologist, the higher the likelihood that the doctor will successfully carry out the necessary manipulations without resorting to surgery.

As soon as the pain subsides and swelling decreases, physiotherapy is recommended. Physiotherapeutic treatment allows you to reduce the risk of developing delayed complications and quickly return to your usual physical activities. Old dislocations require longer treatment using special devices and long-term rehabilitation.

Rehabilitation period

What can you do in the first 2-3 days if a person has sprained his leg? Rest, ensuring the rest of the injured limb. But, if there is no dislocation or fracture, it is advisable to start loading it on the third day. This will make the healing process faster. In difficult cases, full recovery takes up to three months, and then it may make sense to use crutches at first.

Soreness is relieved with a cold compress. You can use a towel soaked in ice water, or ice in a heating pad wrapped in thick cloth. On the first day, the compress is applied every 3 hours and kept for 15–20 minutes. During the procedure, it is necessary to monitor so that frostbite does not set in. If the skin turns white, the cold is immediately removed and the leg is warmed until blood circulation is completely restored.

To prevent the ankle from swelling after a sprained leg, it is advisable to provide moderate compression. You can wear special pressure socks (stockings). An elastic bandage will also work. They wrap part of the lower leg (10–15 cm upward) and the foot (to the base of the toes). Excessive pressure should not be allowed, otherwise problems with blood supply will begin.

During the rest period, the leg is slightly raised, placing a small soft cushion (pillow) under it. This reduces the risk of developing swelling. In the absence of contraindications, painkillers and anti-inflammatory ointments containing paracetamol and ibuprofen are used to alleviate the condition. Troxevasin and heparin ointment help with hematomas and edema. The doctor will give more precise recommendations on how and what to treat the injury after twisting the foot.

After an injury, you should not take hot baths or massage. In this case, if you twisted your leg the day before, it will become very swollen due to the flow of blood to the site of injury. This can subsequently cause inflammation. Naturally, you can’t play sports.

First aid rules

What to do if someone twisted their lower limb? First aid for a sprained leg includes:

Applying a bandage to the injured foot. For this, use an elastic or regular bandage. They start bandaging the leg from the toes.

Positioning the limb above the level of the victim’s head in order to prevent the development of severe edema.

Applying a cold compress. Ice wrapped in a cloth or a bottle of cold water are suitable for this purpose. The compress is applied for 5-7 minutes, after which a break is taken so as not to overcool the foot.

Taking painkillers (Ibuprofen, Analgin, Pentalgin) if the victim cannot tolerate pain.

What is not recommended to do

If we are talking about how to minimize unpleasant consequences and prevent possible complications during treatment at home, then the following rules should not be neglected. For this it is important:

Refrain from hot baths at least in the first days after injury: hot water accelerates blood flow, which increases inflammation and swelling in the damaged area.
Reduce motor and physical activity, overcoming pain: this way you can cause even more harm to the diseased joint.
You should not massage the area next to the injury: this will increase blood circulation, which will result in swelling, and in some cases, bruising may occur.
Try to avoid too long rest or rest - for the first couple of days it is advisable to refrain from sudden movements and active movements, and already on the third day after a sprain or bruise, you can gradually increase the load (lean on the injured leg), but in the case of fractures or dislocations, the methods and timing of healing Only the attending physician can advise on injuries.

If you follow these simple rules, you can prevent negative consequences from injury, and for preventive purposes, when complete recovery occurs, doctors recommend using comfortable shoes with orthopedic insoles.

Fracture

When a fracture occurs, a complete or partial disruption of the integrity of the bone occurs under a load exceeding the strength of the injured area. The most vulnerable places on the hands are the wrist and forearm. On the legs are the ankles, shin bones and femoral neck.

Characteristic signs: an open fracture is visible to the naked eye. A closed one will result in severe pain (such that it is impossible to move the affected limb), deformation of the affected area of the bone, rapidly increasing swelling and hematoma.

What is dangerous: improper fusion or non-fusion of the bone of the limb, damage to surrounding soft tissues, nerve endings, infection of the wound at the site of the open fracture.

What to do: use a special splint, stick, board, or piece of plywood to fix and immobilize the injured limb. If the bones of the forearm are broken, the wrist and elbow joints are immobilized. If the humerus is damaged - the elbow and shoulder joints. In case of a fracture of the femur, the hip and knee joints are fixed (the splint is attached with one end to the body along the side surface, the other to the lower leg and foot), the lower leg - the knee and ankle. If nothing is at hand, the injured leg can be bandaged to the healthy one, and the broken arm to the torso; apply cold to the fracture site; in case of an open fracture, treat the wound with an antiseptic (iodine, brilliant green, vodka) and apply a sterile bandage. Pre-treat the contaminated wound with hydrogen peroxide.

Where to go: to an ambulance or to the nearest emergency room. Do not step on the injured leg under any circumstances, so as not to complicate the fracture.

Prevention of an injured ankle

Ankle joint injuries are insidious - they will constantly remind you of themselves, once you sprain your ankle: a person is constantly at risk when playing sports, wearing the wrong shoes or making awkward movements. In order to prevent undesirable consequences, it is necessary to follow preventive measures:

Select and wear comfortable, high-quality shoes that match your foot size and are comfortable when walking (it is advisable for women to prefer low-heeled shoes, because stylish stiletto heels increase the risk of re-injury).
Strengthen the muscles of the ankle joint (this can be done with the help of special exercises).
When starting to play sports, it is important to warm up in order to warm up your muscles well before the upcoming load.

The main thing to remember is that staying alert and careful is the first rule to avoid sprains and/or serious ankle problems. After all, as follows from the complaints of victims, in most cases, ankle injuries occur precisely because of elementary inattention: people often do not look at their feet. It's corny, but true.

Preventive measures.

Full weight bearing on the leg is allowed no earlier than after a month (for uncomplicated dislocations) or after three (for severe injuries). Crutches may be used during this time if necessary.
After an ankle injury, the patient must wear orthopedic shoes with arch support for a year
Regular physical activity to strengthen the muscles of the lower extremities
Compliance with safety precautions at work, when playing sports, when moving on slippery surfaces
Your daily diet should include foods rich in vitamins and calcium.