Foot and Ankle Trauma

The foot and ankle in the human body work together to provide balance, stability, movement, and propulsion.

This complex anatomy consists of:

• 26 bones
• 33 joints
• Muscles
• Tendons
• Ligaments
• Blood vessels, nerves, and soft tissue

Foot and ankle trauma refers to the injuries that most commonly occur during sports, exercise or any other physical activity. Trauma may be a result of accidents, poor training practices or use of improper gear. Injuries may also be caused when an individual is not medically fit or because of insufficient warm up and stretching exercises.

Ankle injuries are the most common sports-related injury. But you don't necessarily have to be an athlete as walking on an uneven surface can result in twisting of the ankle. The most common ankle injuries include sprains, strains, and fractures.

Ankle Sprains

A sprain is the stretching or tearing of ligaments, which connect adjacent bones in a joint and provide stability to the joint. An ankle sprain is a common injury and occurs when you fall or suddenly twist the ankle joint or when you land your foot in an awkward position after a jump. It most commonly occurs when you participate in sports or when you jump or run on a surface that is irregular. Ankle sprains can cause pain, swelling, tenderness, bruising, stiffness, numbness in the toes, and inability to walk or bear weight on the ankle.

The diagnosis of an ankle sprain is usually made by asking the history of injury and physical examination of the ankle. X-ray of your ankle may be needed to determine the extent of injury.

The most common treatment recommended for ankle sprains is rest, ice, compression and elevation (RICE).

• Rest: You should not move or use the injured part to help to reduce pain and prevent further damage. Crutches may be used to help in walking.
• Ice: An ice-pack should be applied over the injured area up to 3 days after the injury for 20-minute sessions. You can use a cold pack or crushed ice wrapped in a towel. Ice packs help to reduce swelling and relieve pain. Never place ice directly over the skin.
• Compression: Compression of the injured area helps to reduce swelling and bruising. This is usually accomplished by using an elastic wrap for a few days to weeks after the injury.
• Elevation: Place the injured part above heart level to reduce swelling.

The doctor may also suggest a brace or splint to reduce motion of the ankle. Anti-inflammatory pain medications may be prescribed to help reduce the pain and control inflammation. Avoid pivoting and twisting movements for 2 to 3 weeks.

To prevent further sprains or re-injury you may need to wear a semi-rigid ankle brace during exercise, special wraps, and high-top tennis shoes for support. A program of ankle exercises will also help to prevent re-injury by making the ankles strong and flexible.

Ankle Fractures

An ankle fracture is a break in one or more bones that make up the ankle joint. Sometimes ligaments may also be damaged. Ankle fractures are most often caused by motor vehicle accidents, rolling or twisting of the ankle, and by tripping or falling. People participating in sports such as basketball, football, soccer and skiing are at a high risk of developing ankle fractures.

Common symptoms of an ankle fracture include pain and swelling around the ankle, bruising, tenderness, inability to walk on the leg, and deformity if the ankle is dislocated.

Following an ankle injury, it is important to have the ankle evaluated by your doctor for proper diagnosis and treatment. Diagnosis is made based on the history of injury and physical examination of the ankle. In addition, the surgeon may order X-ray of the ankle to determine the extent of the injury.

Treatment varies with the type and severity of the injury. The common method of treatment of ankle fractures is adequate rest, ice application, leg elevation, and medications to reduce swelling and pain. A short leg cast or a brace may be applied over the fractured ankle to provide support. If there is severe injury, excessive swelling or severe pain, you should seek immediate medical treatment.

Some ankle fractures are treated with a splint, which is placed on the ankle for a few days until the swelling subsides. Once the swelling decreases a cast may be placed on the ankle to hold the broken bone in place. Surgery may be needed to realign the bones before placing the splint. During surgery, your doctor may place metal screws, plates, or rods to hold the broken bone intact until healing happens. In some cases, crutches may be used to prevent weight bearing on the ankle.