Published on: December 16, 2019 | Updated on: January 14, 2024
Broken or fractured ankles are amongst some of the most common injuries people accrue throughout their lives. Typically, if an ankle is fractured, tearing of ligaments and soft tissue occurs. The ankle is a crucial structure for standing and walking because it offers support and stability. Therefore, a broken ankle can be devastating to the quality of a person’s life.
It might take a long time for an ankle fracture to heal. 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.
Anatomy of 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: also called the shin, is the major bone of the lower leg which connects the knee and ankle joints.
- The fibula: the smaller leg bone which starts at the tibial head (knee joint) and runs parallel to the tibia down to the ankle joint.
- The talus: a small crater-like bone that provides a stabilization point. This bone connects the calcaneus (heel bone) to the tibia and fibula before they contact the bones of the foot.
- Ligaments/Tendons: The ankle is stabilized with roughly 4 major ligaments.
Together, these three bones and ligaments make up the foundation of the ankle joint.
Among these bones is an intricate system of ligaments, tendons, muscles, and cushioning tissues which act together to provide the fluid, comfortable motions that 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 its relative location, weight-bearing capacities, and general purpose (to provide forward thrust), the ankle is especially susceptible to harm. If any of the tissues within the ankle begin to malfunction, the nerves can send signals to the brain that 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. Over time, 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.
Diagnosing a Broken Ankle
Despite any pain or discomfort, you may experience after an ankle injury, the structures within the ankle may not be broken. While symptoms for any ankle injury are similar, a proper clinical diagnosis is the only way to know if a break has occurred.
Doctors will first examine a patient’s medical history to aid in the diagnostics. They will look for any signs of degenerative illnesses within the ankle, past injuries, the patient’s lifestyle, and other evidence of dysfunction.
By stretching the ankle and applying pressure to various “hot spots” doctors can pinpoint which tissues may be triggering ankle pain. If a 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 a break in the bone, a 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 Treatments and Recovery
A vast amount of ankle fractures are treated without surgery. Minor breaks or tears to the structures of the ankle may heal with simple at-home treatments such as support braces and over-the-counter medication, but for worse injuries, doctors may need to perform simple operations in order to ensure proper recovery.
The key factor in determining whether surgery is necessary or not is if the ankle has been dislocated or fractured. If it has, doctors will need to operate on the ankle to restabilize the bones and muscles in order to make sure they align correctly.
While the severity and invasiveness of the surgery depend on the injury, most 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 decrease.
- Day of surgery: Surgical intervention for a broken ankle is called an open reduction and internal fixation (ORIF). During an ORIF, patients are placed under anesthesia while their ankle is restabilized by the surgeon. Once the bones, muscles, and soft tissues are back in their proper order, surgeons may use several special tools such as screws, plates, rods, wires, or nails to affix the bones 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. Patients should avoid applying any weight on the operated ankle immediately following surgery.
- 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 2-4 weeks post-surgery.
- 1 Month after surgery: by now, most patients 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 to their ankle. Light swelling and pain may occur, this is normal and to be expected as the ankle returns to normal. A physical therapist may be recommended 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. Rigorous activity and extensive loads on the ankle should still be avoided. If patients experience extensive pain or swelling, they should go see the doctor. Some patients may need secondary surgery to remove any plates or other special tools used to stabilize the ankle.
- 6 months after surgery: At this point, patients should regain full ankle function. However, the ankle will be more susceptible to damage moving forward, especially in older or overweight patients.
Ankle fractures are particularly difficult to recover from due to our everyday reliance on the ankle for movement. The recovery can be long and arduous. Luckily, there are alternative options such as regenerative therapies that patients can take to hasten recovery times and return to full functionality.
Regenerative Therapy for Treating a Broken Ankle
Due to the complicated nature of the structures within the ankle, several different types of tissues may be affected after sustaining an injury, regardless of surgery or casting/bracing.
Patients who have experienced surgery firsthand know that long recovery periods can be difficult for their everyday lives – recreational activities are brought to a halt, work and social life may be disturbed, and other health issues may arise due to the lack of activity.
With so much to lose during these recovery periods, patients may seek out alternative forms of treatment to hasten the broken ankle recovery process. Thankfully, regenerative therapies are relatively new treatments that 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 that uses platelets isolated from a patient’s blood 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 up recovery.
Once inside the body, PRP injections from a ‘mess’ (technically called fibrin-crosslinking) onto an injury and send out chemical signals which take 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, autologous stem cell transplantation using either bone marrow or adipose (fat) derived stem cells, may provide similar regenerative results. Recent advancements in stem cell sciences have led to the discovery of a process that excites adult tissues into a pseudo-stem cell state. Once in this state, these cells become multipotent and can diverge into almost any cell in the body.
By harvesting fat or bone marrow or adipose-derived stem cells from a patient, making these tissues undergo the pseudo-stem cell process, and transplanting them back into the site of injury, our doctors can provide the body with a way to create an environment suitable for repair.
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.
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CELLAXYS does not offer Stem Cell Therapy as a cure for any medical condition. No statements or treatments presented by Cellaxys have been evaluated or approved by the Food and Drug Administration (FDA). This site contains no medical advice. All statements and opinions are provided for educational and informational purposes only.