The ankle is part of the ankle joint. It is also often called the ankle. Visually, this is a recognizable bone on both sides of the foot above the heel. The ankle at the ankle joint is the area where the ligaments are attached. When moving, it simplifies the turns of the foot and corrects the direction of movement. The ankle is the vulnerable part of the ankle. Increased loads can provoke its pathologies, and injuries also often occur.
Features of injury
Ankle injuries occur very often. First of all, they are associated with high loads that the joint of the foot and lower leg has to withstand during human movement. In most cases, when exposed to force, bone tissue is not destroyed, but partial or complete rupture of the ligaments occurs.
Only under high loads does the bone tissue break down, leading to a fracture. Typically, the risk of such injuries increases among professional athletes and people who engage in heavy physical work. Ankle fractures often occur when the ligaments of the ankle joint are weak.
To prevent ankle injuries, you should wear comfortable shoes. Constantly wearing high-heeled shoes causes problems. A sedentary lifestyle and sedentary work weaken the ankle ligaments.
Anatomy
The human ankle has the shape of two bony processes. The lateral (outer) ankle is a formation at the lower end of the fibula, and the medial (inner) is in a similar part of the tibia. The fibula and tibia form the tibia, the part of the leg from the foot to the knee. The ankle is a formative element of the ankle joint - a movable joint between the lower leg and foot.
The lower ends of the bones of the lower leg, including the ankles, form the upper part of the ankle joint and, like the fork, which is clearly visible in the photos demonstrating the structure of this joint, cover its lower part - the articular surface of the talus of the foot. A durable bone fork allows you to:
- evenly distribute the high load (weight of the human body) on the bones of the foot;
- move the lower leg relative to the foot in different directions.
Thus, the medial ankle is responsible for turning inward without lifting the foot off the floor, and the lateral ankle is responsible for turning outward. The “fork” formed by the outer and inner ankles ensures high mobility of the foot during flexion and extension, which provides a person with free movement. At the same time, this structure significantly limits the lateral abduction of the foot - this protects the bones and ligaments from excessive stress.
The articular surface of the outer and inner ankles is covered with cartilage, which ensures the free sliding of the bones of the joint relative to each other, protecting them from injuries associated with friction.
The ankle is surrounded by ligaments - dense and at the same time elastic formations, consisting of bundles of connective tissue that hold the bones of the skeleton in their normal position. Without ligaments, the supporting function of the skeleton would be impaired - the bones would simply “move apart” at the places of their articulations.
Attached to the medial malleolus is the medial ankle ligament, which connects the tibia of the leg to the talus of the foot.
On the lateral malleolus are:
- the anterior and posterior tibiofibular ligament, connecting the external malleolus to the corresponding surfaces of the tibia;
- anterior and posterior talofibular ligaments, which provide connection to the talus;
- The calcaneofibular ligament connects the outer malleolus (and by extension the fibula) to the calcaneus.
Most often, the cause of decreased mobility in the ankle area is damage to the ligamentous apparatus. The most common injury to the ankle is traumatic injury.
Ligament damage
When sprained during movement, damage to the ankle ligaments occurs. In severe cases, their complete or partial rupture may occur.
Damage to the ankle ligaments in the ankle area is always accompanied by micro-tears of the connective tissue. Because of this, hemorrhages and accumulation of intercellular fluid occur, which leads to pain. They intensify when walking and standing for long periods of time.
Minor sprains can occur from walking for long periods of time without twisting or impacting the foot. The risks increase if people lead a sedentary lifestyle. The following signs indicate significant ligament damage:
- Swelling of the ankle, and in severe cases of the entire lower leg.
- Loss of ankle mobility.
Causes of swelling of the ankles (ankles)
There can be many reasons why ankles (ankles) swell. Here is an example of just a few of them:
- Injuries to the foot or ankle
- Side effect of some medications
- Inflammation of subcutaneous fat (cellulite)
- Varicose veins complicated by chronic venous insufficiency
- Venous thrombosis
- Pregnancy
- Preeclampsia
- Pathology of the kidneys or liver
- Hypothyroidism
One of the main reasons why ankles (ankles) swell is varicose veins. With varicose veins, swelling is caused by disruption of the valves of the venous vessels of the lower extremities. These valves provide physiological return of blood to the heart. It is this mechanism that is damaged in varicose veins, resulting in reverse blood flow and blood stagnation in the distal parts of the lower extremities.
Ankle swelling at the end of the day
Decompensation of the condition leads to swelling of the ankles.
Fractures
Ankle fractures can occur for a variety of reasons. Direct injuries occur upon impact. Most often, this occurs during an accident when a heavy object accidentally falls on the leg. Indirect fractures are more common. They usually occur when the leg twists. In this case, the injury is accompanied by the formation of bone fragments and dislocation of the foot and sprained ligaments. As a rule, it occurs when falling on ice or a slippery floor, walking on an uneven surface, etc.
If the fracture did not cause displacement of bone fragments and severe sprain of the ligaments, then swelling and tolerable pain are noted against the background of difficulties with joint mobility. In more severe cases, there is intense pain and an absolute inability to step on the injured leg. In addition to swelling, bruising is often present in the ankle area. With an open fracture, there is a wound through which bone fragments are visible.
Interesting Facts
The structure of the human leg
For the first time, a detailed sketch of the structure of the lower limb was drawn by Leonardo da Vinci. His drawings are still popular among modern anatomists. He imagined the human leg as a mechanical formation that has its own laws of movement and structure. This allowed us to open our eyes to the features of the articular surfaces of the ankle and knee joint.
Leonardo described all the names of anatomical structures in Latin. The artist wrote inscriptions in Latin even near the smallest area, describing its shape and structure.
He believed that a description of the anatomy of any part of the human body without pictures and illustrations is uninformative. After all, it is better to see once than to hear or read hundreds of times.
The artist made the image of the foot so detailed and natural that one can easily examine the structure and study the biomechanics of the foot.
Even modern photographs cannot characterize the location of a person’s ankle and its structure in as much detail as the artist’s drawings.
Features of treatment
If, after examination by a doctor and diagnostics, minor ligament damage is confirmed, then it is necessary to ensure maximum rest for the sore leg. Cold compresses are indicated. Ice is applied to the sore spot during the first 24 hours after injury. If necessary, painkillers are prescribed and orthoses are worn to fix the ankle. In severe cases, when the ligaments are torn, surgical treatment is performed.
In case of a fracture, a plaster cast is required. Strong painkillers are prescribed to relieve pain. If bone displacement is confirmed, surgery is performed. An ankle fracture requires professional treatment. Otherwise, foot function may be impaired.
With correct treatment, it will take 6-8 weeks for the bones to heal in an ankle fracture. During this period it is necessary to wear a cast. You should also avoid any stress on the injured leg. After the cast is removed, you will need to wear special shoes for a certain time and periodically take x-rays to monitor the recovery. The duration of complete rehabilitation usually takes about a year. During the recovery period, calcium-rich foods should be included in the diet. Massage and physical therapy are also indicated.
Possible complications
After treatment, it is important to follow your surgeon's instructions. Failure to do so can lead to infection, deformity, arthritis, and chronic pain. Source: Mistakes and Complications in the Treatment of Compound Ankle Fractures. Salikhov R.Z., Pankov I.O., Plakseychuk Yu.A., Soloviev V.V. Practical medicine, 2014. p. 128-131.
Article sources:
- Errors and complications in the treatment of complex fractures of the ankle joint. Salikhov R.Z., Pankov I.O., Plakseychuk Yu.A., Soloviev V.V. Practical medicine, 2014. p. 128-131
- Analysis of ankle joint injuries. Taylashev M.M., Salatin P.P., Sobolev V.V., Pozikov V.V., Kolesnikov A.S. Acta Biomedica Scientifica, 2008. p. 144-145
- Comprehensive diagnosis of ankle joint injuries. Kim L.I., Dyachkova G.V. Genius of Orthopedics, 2013. p.20-24
- Fractures of the ankle joint and treatment methods. Cherednik A.A., More Gautam Saherbao, Al-Fakih Abdulaziz. Bulletin of Medical Internet Conferences, 2014. p.432
- Therapeutic tactics for intra-articular fractures of the ankle joint (literature review). Zedgenidze I.V., Tishkov N.V. Acta Biomedica Scientifica, 2013. pp. 178-182
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Swelling of the ankles
A fairly common pathological condition is swelling of the ankles. They occur without exposure to any traumatic factor. In most cases, this is due to excess weight and a sedentary lifestyle. Due to increased stress, edema often occurs during pregnancy. When such symptoms appear, it is important to dose out physical activity and drink less fluid.
Swelling of the ankles can be a symptom of various diseases: heart, kidney and liver. In addition, urinary tract infections are a common cause of pathology. Swelling of the ankles may indicate the onset of venous insufficiency. In this case, after a certain time, changes in the appearance of the skin will appear, and in severe cases, ulcers will appear and the risk of infection will increase.
If swelling of the ankles occurs, you should immediately contact your local physician. To treat swelling of the ankles, the cause of the pathological condition must be established. After this, measures are taken to treat the specific disease. In any case, therapeutic exercises can stabilize the condition. It is also important to wear comfortable orthopedic shoes when swelling occurs. For persistent swelling, herbal diuretics are prescribed. Foot baths and massage are recommended at night.