An ankle is a lump-like growth on the leg. It consists of the lateral malleolus, which is located at a distant distance from the center of the fibula and the middle (medial) malleolus, forming the so-called “fork” of the joint in the ankle area. This structure allows the person’s weight to be evenly distributed evenly on the lower leg. A bimalleolar fracture (a fracture of both bones) occurs quite often in the practice of a traumatologist, as does a fracture of the tibia. It is a serious injury, since if you do not consult a doctor promptly, you can permanently lose the normal functioning of the ankle joint.
Such injuries occur when the foot is dislocated inward or outward, and the ankle itself takes the blow. This injury is characterized by a rather painful condition.
Anatomy of the ankle
The ankle joint is made up of bones that are connected to each other - the tibia, tibia, and talus. The ankles are the protruding part of the bones. When they are connected, an ankle is formed, which has an inner and outer part. The fibula lies parallel to the tibia. This creates the literal ankle and outer part. The protruding bones resemble a fork, surrounding the talus on three sides.
At the ankle, the joint is surrounded by a membrane that contains synovial fluid. Due to it, the bones are ensured normal functioning, they can move without problems, without interfering with each other.
Normal functioning of the ankle is achieved through ligaments that support the bone union in the desired position. The ligaments present in the joint are:
- fibular calcaneus;
- Deltoid;
- Peroneal talus - anterior and posterior.
In addition to the above-mentioned ligaments, the tibiofibular syndesmosis, which connects the fibula and tibia, takes a significant part in the work of this part of the leg.
Possible causes of double fracture
A fracture of both ankles can occur due to mechanical impacts. They must be strong enough to break the integrity of the bone. Injuries most often occur due to falls; if you land unsuccessfully on a foot that turns in, the ankle may twist at an awkward angle or bend or straighten incorrectly. The cause of a fracture can also be a blow of great force, or a heavy object falling on this area.
Fractures are considered occupational injuries for people who engage in active sports. Footballers, cyclists, and wrestlers break bones several times more often than ordinary people. Also, people with weakened bones due to age - children, elderly citizens - are very susceptible to this type of injury.
People suffering from various diseases - oncology, osteoporosis, and other problems with the skeletal system - are also susceptible to fractures. In such cases, bone integrity can occur even due to a fairly harmless injury. Ankle weakness due to genetic characteristics also plays an important role in susceptibility to injury. People of any age with a diagnosed “habitual dislocation” of the foot are predisposed to fractures.
Fractures of both leg bones are classified according to the following criteria:
- Open and closed options;
- With and without offsets;
- With dislocation or subluxation.
It is very rare when a bilateral ankle fracture occurs without rupture of the ankle ligaments
Precautionary measures
To prevent ankle injuries, you must first of all follow safety precautions during icy conditions (according to statistics, about 60 percent of injuries occur during icy roads).
ADVICE! To increase traction between the sole and the ice, you can glue a small piece of sandpaper to your boots.
Shoes should fit tightly around the ankle and have a stable sole. A heel with a support area of less than 2 square centimeters can cause a twisted ankle.
Fracture diagnosis and symptoms
Compromise of the lateral ankle can occur due to a rupture of the deltoid ligament of the ankle. In this case, the inner one may remain unharmed, but the manifestations may suggest fractures of both ankles, since the ligament comes from the inner segment.
Signs of fractures may include:
- Hematoma in the injured area due to hemorrhage;
- Severe pain;
- Swelling and deformation of the limb;
- It is painful to step on a broken leg;
- Leg mobility is limited;
- With an open fracture, the skin is torn, bleeding begins, and bone fragments can be seen in the wound.
First aid
A double-malleolar fracture is a difficult injury that cannot be cured on its own.
It is necessary to call an ambulance to a person with a possible fracture, and before the specialists arrive, try to reduce the patient’s suffering.
He needs to take pain medication - this could be taking a pill or giving an injection. Then you need to stop the bleeding. The injured limb is immobilized by applying a splint.
When the medical team arrives at the scene, the victim will be transported to the hospital. During transportation, the injured leg is positioned so that it is much higher than the body - this helps reduce swelling. Cold may be placed on the affected area to reduce bruising and swelling.
It is necessary to ensure immobilization of the affected limb. It consists of the following events:
- A plaster cast 8-12 cm wide is applied to the injured area. Its boundaries begin from the proximal region of the upper third of the leg. Then the fixing bandage is brought to the ankle joint, heel, and lateral malleolus.
- The bandage must be reliable - for this, a 15-centimeter splint is applied to the back of the shin. It should cover the top and bottom of the shin, and end near the sole.
- The doctor should pay special attention to the degree of swelling of the limb and the color of the fingers on it. The tactics used for treatment will be determined depending on the presence of these symptoms.
Displaced ankle fracture
A displaced ankle fracture can be caused by a fall, a fall from a ladder, or while playing extreme sports. Most often, such fractures are caused by skiing, skating and roller skating. A displaced ankle fracture can occur as a result of an unsuccessful parachute jump.
In case of a displaced ankle fracture, which occurs when a person falls from a height, with the foot twisting both outward and inward. This displacement of ankle fragments can lead to perforation (tear) of the skin in the area of the fracture. In such cases, it is necessary to contact a qualified specialist, a traumatologist, to provide medical assistance. Often, ankle fractures are not diagnosed because the person does not see a doctor immediately after the injury.
Many people self-medicate, and after 2-3 weeks nothing helps, they turn to a traumatologist. This is irresponsible and wrong. Old ankle fractures require difficult and lengthy treatment. As a rule, with chronic injuries, ankle fractures are complicated by the development of deforming arthrosis of the ankle joint.
Treatment of fractures
Before making a decision on the treatment of an injured limb, the doctor will examine the patient and draw up a picture of the disease based on his complaints. The victim is then sent for an x-ray. The data obtained as a result of the procedure will help to more accurately determine the nature of the injury.
Once there is no doubt about the diagnosis, the doctor prescribes treatment measures. Ankle fractures are treated using conservative or surgical methods, depending on the patient’s condition.
Conservative treatment of 2 ankle fractures
The use of conservative treatment implies the inevitable reduction of bone fragments. Then a plaster cast is applied, which will need to be removed no earlier than after 6 weeks. After 6-12 weeks, the rehabilitation period begins. The patient will need to use a device called an orthosis to improve the condition of the ankle.
When the fracture is closed, the skin will not be torn. With an open fracture, the doctor can see bone fragments through the wound. A closed bimalleolar fracture of the left or right tibia is much more convenient and simpler to treat. Anesthesia is performed, after which the traumatologist will try to set the damaged bones. Manual manipulations will be performed on the injured leg - the doctor bends the limb, then begins to apply forceful pressure to the foot. This effect helps return the bone to its proper place. When it is set, a plaster cast and, if necessary, a splint are applied.
If, as a result of the examination, a bimalleolar fracture with subluxation of the foot is diagnosed, an additional examination of the fingers is carried out - this way the degree of swelling will be determined. The patient is then sent back for x-rays. This will help ensure that the bone fits into place as it should.
Diagnosis of injury
To make an accurate diagnosis, the traumatologist is required to carry out a number of the following activities:
- take a patient's medical history. It is necessary to find out in detail how the injury was received, under what circumstances and in what position;
- take into account all the patient’s complaints;
- prescribe an examination using x-rays of the foot, as well as the ankle joint. X-rays are performed in two projections;
- For a more accurate diagnosis of injury, repeated X-rays and, in some cases, CT (computed tomography) are prescribed.
Rehabilitation
For a bilateral ankle fracture, the following rehabilitation measures are carried out:
- Massotherapy;
- Physiotherapeutic procedures;
- Gymnastics to provide a therapeutic effect;
- Application of an orthosis.
What are the tasks of the recovery period:
- Functionality should be restored in the ankle;
- Traumatic flat feet are prevented;
- Swelling of the limb is eliminated;
- Restoration of blood circulation;
- Prevention of foot and joint deformities;
- Preventing the formation of curvature;
- Prevention of the formation of heel spurs.
To reduce swelling in the ankle area with a double ankle fracture, the patient is prescribed warm baths in the morning and evening. The water temperature should be comfortable; you can add a herbal decoction with a calming effect or sea salt to it.
It is recommended to lie for about 15-20 minutes every day with your legs raised 120 degrees.
In addition to therapeutic massage, patients may be advised to independently stretch their lower leg and foot. When performing massage movements, you must be careful, start warming up from the foot and lower leg, gradually moving up to the knee joint.
During the recovery period after a fracture, you should use an elastic bandage, wrapping it around the affected leg from the toes to the knee.
It is permissible to remove the bandage during rehabilitation only before going to bed, for massage or therapeutic exercises. The most useful type of exercise at this time is swimming.
Folk remedies for recovery and rehabilitation
- An ointment based on rose ether and mumiyo (in a 1:1 ratio) stimulates the outflow of lymph and restoration of blood circulation.
- Mumiyo can be taken orally by diluting 0.2 grams of powder per 50 grams of liquid in hot water. For children, the dosage is different: 0.1 grams of the drug per 50 grams of liquid.
- Copper sulfate, if diluted with a base oil (sunflower, coconut or olive), can give a good calming effect. Vitriol promotes regeneration processes.
Useful tips
For at least six months after illness, you need to take care of yourself. Avoid sports that involve jerking. Do not run or jump, avoid sudden tension. When performing physical activity, you should consult your doctor.
For greater effect, the rehabilitation program must be combined with properly selected nutrition.
You should add more vitamins and calcium to your diet. If the amount of calcium you can get from food is not enough, your doctor will prescribe it in pills. To get vitamins in the right quantities, you should add more fruits to your diet.
If treatment is carried out at the wrong time or incorrectly, the fracture will most likely heal with serious complications. The success of treatment will largely depend on the experience of the doctors treating the patient. But the speed and quality of recovery after an ankle fracture largely depends on the diligence of the patient.
How to speed up bone healing after a fracture
In order for injured bones to heal as quickly as possible, they need a constant supply of vitamins, in particular calcium, to the body.
It is found in large quantities in eggshells. It can be ground with a coffee grinder to a powdery state and added in small proportions to food. It is also recommended to introduce as much dairy products of natural origin into your food as possible. Another large amount of calcium is found in fatty fish and legumes. For improved absorption of calcium entering the body, sufficient consumption of foods containing flint is necessary. It is this element that is responsible for how well the human body absorbs incoming calcium. Silicon is found in large quantities in vegetables, as well as in berries. Silicon is also found in significant quantities in cauliflower and radishes, as well as in natural olives.
If you decide to replace natural sources of vitamins with pharmacy options, you must consult a specialist before using them.