Ankle fracture

General

In most cases, an ankle fracture affects the upper part of the joint, also upper ankle called. The upper ankle is the connection between the bone of Lower leg and des Foot. Fractures that affect the ankle are a very common injury. The ankle joint represents the total third most common Localization for bone fractures in humans. Fractures at this point are particularly common in one Buckling of the foot up and puts a classic sports injury there, why often young, sporty people are affected by the injury.

The fractures do not always occur in the same place and can be divided into different categories depending on the findings. In medicine there is one Classification according to Weber A, B or C Common fracture. This classification is based on the height of the fracture and the impairment of the so-called Syndesmosis, the connection between the two bones on the lower leg.

Treatment of an ankle fracture is most common surgically and provides stabilization of the bone as well as that Positioning the bone fragments in the initial state in the foreground. Here are often Screws and plates used, which can be removed after the bones have healed. The prognosis for an ankle fracture depends on that extent of injuries, but usually works out very well. Especially when the recommendations of the medical staff are followed, is one full load on the ankle is possible again after a while.

Symptoms

Ankle fractures are especially common in one Buckling of the foot on. If the affected person twisted ankle and notices symptoms that could indicate the presence of an ankle fracture, a doctor should be consulted in any case.

Typically, ankle fractures occur, as they do with others Broken bones on the body, severe pain immediately after the trauma. Especially when trying the burden of the foot or at pressure usually step on the affected area strong pain on. A few minutes after the trauma, there are usually other symptoms that indicate an ankle fracture. Such is the formation of one Bruise on the foot typical of the injury. The making of a swelling on the foot is another, rather unspecific symptom of the ankle fracture. There may also be general symptoms such as nausea and Vomit occur at such a break.

If the fracture is open, one or more bone fragments will pierce the skin and be visible. Only in this case can an ankle fracture be diagnosed by visual diagnosis without further diagnostic measures.

causes

The causes that can lead to an ankle fracture are numerous. By far the most common cause of these fractures is the Buckling of the foot on. Especially in running-intensive sports and in To ski Ankle fractures are common. But also with Falling on the foot and twisting at the same time as well as through traffic accidents fracture of the ankle can result. In most cases turns the foot inwards and thus creates a pressure on the bones of the ankle joint, which they cannot withstand and then break. In this form of injury is medicated by one Supination trauma spoken.

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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
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Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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therapy

The individual therapy is basically based on the extent the injury as well as the Soft tissue impairment, of the localization the bone fracture as well as factors such as the Age the person concerned and any previous illnesses.

In general, however, it can be said that most ankle fractures using a surgery be treated. Only if the bone fragments have not been shifted from one another (dislocated) is conservative therapy and installation of one sufficient Plaster cast out.

Surgical treatment initially focuses on this Merge the bone fragments in their correct position as well as the Fixation of the fragments, mostly using plates and Screws. Depending on the type of fracture and its location, the therapy can be very complex and a large number of screws are sometimes required to secure the stability of Bone to ensure. If the syndesmosis is also affected, as is often the case with Weber B or Weber C fractures, the joint must also be treated with a Adjusting screw be stabilized.
For open ankle fractures, taking a Antibiotic important to a infection to prevent the wound.

surgery

In most cases, an ankle fracture is treated surgically. Depending on the extent of the injury and the affected structures, an operation takes place differently. At the beginning of the procedure, the attending physician must have access to the affected structures, which is why a Skin incision he follows. Then the injured structures are exposed and the appropriate ones Fixation in the form of Plates, screws or wires selected. The surgeon often decides which fixation is suitable in each individual case based on the image presented to him during the operation. If soft tissues are also affected by the injury, it can be considered during the operation whether a surgical intervention makes sense for the individual. Be like that ruptured ligaments partially sutured during surgery for an ankle fracture.

After attaching the metallic fixation, the Surgical wound sewn and the patient under the administration of Pain medication awakened again. It is important that a Stress on the foot should also be avoided after the operationin order not to endanger the success of the therapy.

Healing / duration

As a rule, ankle fractures heal completely after a while and the foot can be stressed without restriction. There bone however, it can take a long time to heal completely.

With conservative therapy, it must joint be fixed and no load may be exerted on the foot. This is usually guaranteed by applying a plaster cast. This usually remains around 6 weeks on the foot until it can be removed.

An operation takes place shortly after the injury and provides a Fixation of the bone by directly attaching Screws, wires and plates. Even after an operation, no weight should be placed on the foot: crutches should be used.

After a few weeks, partial weight bearing can occur on the foot and thus on the ankle. With normal healing, this is after approx. 6 weeks the case. When a Full load can take place depends on the success of the therapy and the course of healing. A possibility of full exercise is possible between 2 and 6 months. Sometimes the Duration of healing up to a year continue until all complaints have completely subsided. If the structures of the Ankle and the surrounding soft tissues have been severely damaged, a lifelong impairment of stability in the ankle can remain.

diagnosis

A reliable diagnosis that an ankle fracture is present can be made through the use of diagnostic imaging. The standard examination method for suspected ankle fracture is this X-ray imaging of the joint in two planes. Two X-ray images are created, which can depict the injured structures in such a way that an assessment of the injury can be made. Depending on Extent and location of the injury can the Ankle fracture classified and treated based on the X-ray images become. In the case of complicated injuries, comprehensive recordings are made using a Computed tomograph created.

Weber classification

In Germany, ankle fractures are classified according to the so-called Weber classification. This differentiates the fractures according to their location and the affected structures. It will Weber A, B and C Differentiated fractures. The decisive factor for the individual classification of the ankle fracture is Impairment of syndesmosis. This is the connective tissue connection between the two lower leg bones Fibula and Tibia.

In the Weber A Fracture is the Syndesmosis not hurt and the fracture is below the structure.

The Weber B Fracture is located at the height of the syndesmosis and this can either be ruptured or still intact.

The Weber C Fracture is above the syndesmosis localized and there is a violation of syndesmosis.

The division into the respective Weber classification has a therapeutic consequence and should always be ascertained when diagnosing an ankle fracture.

forecast

In general, if an ankle fracture is present, one good prognosis can be assumed. This is how the impaired heal bone although relatively slowly, as a rule, however, a symptom-free treatment can be achieved. However, the prognosis may deteriorate if the fractures are complicated and the soft tissue is significantly involved. In these cases, a longer therapy and healing time can be assumed. About 6 weeks after starting therapy can with a Partial load of Ankle to be started. Sports, which with significant loads of the ankle joint can sometimes only be after 2-3 months are executed.

prophylaxis

This is important when preventing an ankle fracture Avoid twisting the foot. This can especially be achieved through the use of proper Footwear can be achieved in endangered sports. Stress on the ankle joint when coordination is impaired should generally be avoided

It is difficult to prevent unpredictable accidents, which is why no recommendation can be given for the prophylaxis of these injuries.