Broken or fractured ankles are amongst some of the most common injuries people accrue throughout their lives. Between acute pain, immobility, and concerns of long-term damage, one may want to seek out more information on just what is going on inside the ankle and how they may be able to hasten the healing process.
In this article we will describe the structures inside the ankle, how they may come into harm, and the recovery process for both minor and acute injuries. Continue on if you suspect that you may have fallen victim to ankle injury.
Brief Anatomy of the Ankle
Before we can begin to understand exactly what type of ankle injury we’re dealing with, it may be wise to learn a little bit about the structures within the ankle. Understanding the anatomy behind these types of injuries can help provide valuable insight into not only what’s been injured, but what we can do to mitigate the risks of further injury.
Like most of the joints in our body, the ankle is a meeting point between two extremities, in this case, the foot and the lower leg. Specifically, the ankle joint is the meeting point between three bones:
- The tibia, the major bone of the lower leg which nests into the inside end of the ankle joint.
- The fibula, the smaller leg bone which runs parallel to the tibia and nests into the outside of the ankle joint.
- The talus, a small crater-like bone which cradles the lower ends of the tibia and fibula and provides a stabilization point before they meet the bones of the foot.
Together, these three bones make up the foundation of the ankle joint.
Among these bones is an intricate weave of ligaments, tendons, muscles, and cushioning tissues which act together to provide the fluid, comfortable motions healthy ankle joints make daily. These soft tissues not only hold the ankle together, but also provide anchor points for the movements expressed by our muscles.
Scattered throughout the ankle are tiny nerves which help excite the muscles into movement, supply blood to the ankle, and most importantly, provide sensation to the brain.
Due to it’s relative location, weight bearing capacities, and general purpose (to provide forward thrust), the ankle is especially susceptible to harm. What’s more, if any of the tissues within the ankle begin to malfunction, the nerves within can send signals to the brain which it may interpret as pain or discomfort.
As we age or after sustaining an injury, the soft tissues wear away and bones degrade within the ankle and cause a pain response. Overtime, this pain can become chronic and lead to a host of issues including instability, pain, swelling, and immobility.
The first step in recovery from such an injury is a proper diagnosis.
Broken Ankle Diagnosis
Despite any pain or discomfort you may experience after ankle injury this may not be a sign that the structures within the ankle are actually broken. While symptoms for any ankle injury are similar, the only sure fire way know if something is broken is with a proper clinical diagnosis.
Doctors will look into past medical history – have there been any signs of degenerative illnesses within the ankle, did the patient experience an acute injury in the past, could the patient’s lifestyle have triggered the ankle pain – and move on to a physical examination from there.
By stretching the ankle and applying pressure to various “hot spots” doctors can pinpoint which tissues may be to blame for ankle pain. If traumatic injury is suspected, diagnostic imaging will be used to confirm probable causes.
X-rays, MRIs, and CAT scans are the least invasive medical imaging techniques available. These images will give doctors an inside view of the structures within the ankle and help them identify if there is in fact a break in the bone, tear in the muscles, or a soft tissue rupture.
If these tests turn out positive for a broken ankle, treatment must be swift in order to assure success and sustained functionality of the ankle.
Broken Ankle Treatment and Recovery
Minor breaks or tears to the structures of the ankle may be helped and healed with simple at home treatments such as braces and over-the-counter medication, but for deeper issues doctors may need to perform simple operations in order to ensure proper recovery.
In addition to fractures, one of the key factors in determining whether surgery is necessary is whether or not the ankle has been dislocated. If it has, doctors will need to open the ankle up and restabilize the bones and muscles within in order to make sure they align correctly.
Once a break, fracture, or dislocation has been fully diagnosed, most treatment plans involve some form of surgery. While the severity and invasiveness of the surgery depends on the specific fracture, most surgeries follow a similar routine:
- After diagnosis: doctors will either act swiftly and send a patient into surgery immediately following the discovery of an ankle fracture or they may wait several days to ensure any swelling has had a chance to go down.
- Day of surgery: Surgical intervention for a broken ankle is called an open reduction. During an open reduction, patients are numbed and put to sleep and their ankle is opened up in order to restabilize the tissues within.
Once the bones, muscles, and soft tissues are back in their proper order, surgeons may use a number of special tools such as screws, plates, rods, wires, or nails to affix the bones within into place.
- Immediately after surgery: doctors will monitor the patient’s vital signs as they come off of anesthesia and examine the ankle to ensure that the surgery was successful. Under no circumstances will the patient apply any weight to the operated ankle immediately following surgical intervention.
- 1-2 days after surgery: doctors will order a new set of diagnostic images to examine the internal structures of the ankle. Although chances are minimal, doctors may need to order a second operation if the first was unsuccessful.
If the surgery was deemed a success, doctors will order a cast to be placed over the operated ankle. Patients will be prescribed medication as well as weight bearing devices such as a wheelchair or crutches. Patients will be advised not to place any weight on the ankle and to keep it elevated as much as possible for a period of 2-4 weeks post-surgery.
- 1 Month after surgery: by now, most patient’s will be able to return to light tasks and may be ordered to place some weight on their ankle daily. Patients will be asked to track their recovery and monitor any changes in the temperament of their ankle.
Light swelling and pain may emerge in these first stages after ankle surgery, this is normal and to be expected as the ankle returns to normal.
A physical therapist may be prescribed as the patient begins to move and use their ankle more. Once the cast or brace comes off, physical therapy will intensify.
- 2-3 months after surgery: by this point most patients should have free use of their ankle, albeit within some confines. Rigorous activity and extensive loads on the ankle should still be avoided. Long episodes of pain or swelling should be met with a clinical visit. Some patient may need secondary surgery to remove any plates or other special tools used to stabilize the ankle.
- 6 months after surgery: At this point, ankle function should completely return to the patient, though the ankle will be even more susceptible to damage moving forward, especially in older patients and in women.
Ankle fractures are particularly difficult to recover from due to our everyday reliance on the ankle for movement. Though recovery can be long and arduous, there are many options a patient can take to hasten recovery times and return to their everyday functionality. One such option are regenerative therapies.
Broken Ankles and Regenerative Therapy
Due to the complicated nature of the structures within the ankle, several different types of tissues may be affected after sustaining an injury. Though surgical intervention is highly necessary, this treatment may upset the structures of the ankle even more and create a much longer recovery process.
Patients who experience these procedures firsthand know that long recovery periods can spell the worst for their everyday lives – recreational activities are brought to a halt, work and social life may be upset, and other health issues may arise due to the lack of activity.
With so much of our lives at play during these recovery periods, patients may seek out any form of treatment to hasten the broken ankle recovery process. Thankfully, regenerative therapies are relatively new treatments which have helped many patients overcome their ankle injuries and return to their everyday lives.
These treatments use our body’s natural defense mechanisms to help heal various tissues within our bodies.
Platelet Rich Plasma therapy is one such treatment which uses platelets isolated from a patient’s blood in order to amplify the body’s healing response. These platelets are naturally found in the body, but during treatment they are extracted, isolated, allowed to multiply and mixed with growth factors to help speed recovery.
Once inside the body, PRP injections latch onto an injury and send out chemical synapses which cull resources from the body to the site of an injury. In doing so, the recovery for the specific injury is brought to the top of the queue within the body and allowed to heal much quicker than other, smaller injuries.
In addition to PRP, stem cell therapy may provide similar regenerative results. Recent advancements in stem cell sciences have led to the discovery of a process which excites adult tissues into a pseudo-stem cell state. Once in this state, these cells become multi-potent and can diverge into almost any cell in the body.
By harvesting fat or bone marrow from a patient, making these tissues undergo the pseudo-stem cell process and reinjecting them back into the site of injury, doctors can provide the body with a way to create an environment suitable for repair.
Much like PRP, stem cell injections call on the body’s natural resources to respond to certain wounds and then use these resources to amplify the healing process. Additionally, these cells can magnify cell reproduction and allow for new healthy tissues to form within the environment they create, thus boosting the body’s natural healing responses.
Though most of these treatments are still in the infantile state of approval in the US, they’ve been used the world over in order to help patient will similar acute trauma to that of a broken ankle.
To learn more about what regenerative therapies are and how they might be able to help your ankle injury, contact the CELLAXYS offices today to set up a consultation.